Safety and Culture – Clinician Well-Being Knowledge Hub

A Call to Action: Improving Clinician Well-Being and Patient Care and Safety

NAM — Fri, 13 Mar 2020 13:18:44 +0000

The Health Policy Institute of Ohio collaborated with The Ohio State University College of Nursing Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare to create A Call to Action: Improving Clinician Well-Being and Patient Care and Safety. The Call to Action outlines the bi-directional relationship between clinician well-being and patient care, calls attention to the health problems clinicians face related to burnout, and highlights the need for a comprehensive approach to prevention, treatment, and recovery efforts. As part of this approach, state policymakers and healthcare leaders have an important role in implementing evidence-informed policies and practices such as advancing positive organizational culture, promoting wellness programs, reducing stigma toward seeking mental health treatment, increasing access to mental health services, and monitoring the data on student and clinician wellness.

Exploring Moral Resilience Toward A Culture of Ethical Practice

NAM — Wed, 18 Sep 2019 20:58:54 +0000

This report published by the American Nurses Association discusses a call to action for improving moral resilience in order to address ethical challenges that nurses face. Moral resilience is seen as an important capacity for nurses to cultivate due to the many challenges faced in an inherently stressful environment. Transforming individual and team distress along with the organizational culture that contributes to this will create conditions where moral and ethical practice can thrive. The report includes recommendations from an individual and organizational level to apply interventions that foster moral resilience.

The Embedded Counseling Model: An Application for Dental Students

NAM — Wed, 18 Sep 2019 13:36:46 +0000

The aim of this study was to evaluate the impact of a counseling office on dental students at the University of Iowa College of Dentistry & Dental Clinics during their first three academic semesters. A full time psychologist was hired to provide in house counseling sessions to individual students. During clinical assessment, data was gathered on students’ psychological history and high risk behaviors. An outcome rating scale was utilized after each session to assess overall psychotherapy outcome. Results found a positive correlation between the number of counseling appointments and overall functioning. The most significant increase followed after the sessions. This suggests that counseling offices are efficient in promoting well-being of students and further research is needed in this area so that faculty can best meet the needs of their students.

Tackling Stress Management, Addiction, and Suicide Prevention in a Predoctoral Dental Curriculum

NAM — Wed, 18 Sep 2019 13:32:12 +0000

This article, published in Predoctoral Dental Education describes a module designed by the University Of British Columbia Faculty Of Dentistry to address stress management and suicide prevention in dental education. The course includes standardized patients, guest lectures, in-class activities, video presentations, and self-reflections. The purpose of the module is to increase discussion of stress in dentistry curriculum and awareness in dental students. Follow up studies with students who have taken the module are needed to determine its impact on health behaviors.

Medical Licensure Questions and Physician Reluctance to Seek Care for Mental Health Conditions.

NAM — Mon, 09 Sep 2019 16:03:18 +0000

Licensing boards inquiring about mental health diagnoses are believed to cause a substantial deterrent to physicians seeking help, especially those with treatable disorders. This study, conducted by the Mayo Clinic sought to determine whether state medical licensure application questions (MLAQs) about mental health impact a physician’s reluctance, to seek help for a mental health condition. Responses from the applications for questions regarding mental health were collected, along with data on care-seeking attitudes, from a convenience sample of U.S. physicians. Results found that nearly 40% of physicians would be reluctant to seek care for treatment of a mental health condition due to concerns of repercussions. Changing medical licensure application questions so that they inquire about current functional impairment could provide a meaningful step to reducing barriers to seeking assistance.

Systematic Review: Association of Shift Length, Protected Sleep Time, and Night Float with Patient Care, Residents’ Health and Education

NAM — Tue, 23 Jul 2019 19:31:50 +0000

Published in Annals of Internal Medicine, the following systematic review examines the effects of shift length, protected sleep time, and night float on patient care, resident health, and education outcomes among residents. The review finds that a majority of studies find shorter shifts are associated with decreased medical errors, motor vehicle crashes, and per-cutaneous injuries. Only 2 studies assessed protected sleep time and reported that residents’ adherence to naps was poor. Night floats described in 33 studies involved 5 to 7 consecutive nights. Overall, specific recommendations about shift length, protected sleep time, and night float should acknowledge the limitations of this evidence.

Survey of Physician Well-Being and Health Behaviors at an Academic Medical Center

NAM — Tue, 23 Jul 2019 14:50:13 +0000

The following study evaluates the prevalence of and risk factors for psychiatric symptoms and disorders and for personal health behaviors among among clinicians at an academic medical center. The prevalence of current depressive symptoms was 29%; prevalence of high likelihood of harmful alcohol consumption, 6%; the use of sedatives or hypnotics without a prescription in the past 12 months, 5%. The characteristics associated with depressive symptoms were living alone, full time salaried faculty status, not having a primary care physician, female sex, and age < 50 years and risk factors were male sex, house staff status, and not being exclusively heterosexual. The research advises engaging physicians in primary care relationships and social support for those at risk for depression, suicide, and substance abuse.

Role of the Doctor: To Care for Patients’ Well-Being

NAM — Mon, 22 Jul 2019 19:04:05 +0000

Published in BMJ, the following commentary discusses the moral and professional role of physicians. Is the duty to please or to provide informed, professional advice in good faith? The privilege of aforementioned professionalism is one imparted to a physician by society and the preparation is in the compassion, dedication, and education. The irreducible core value, Colman points out, is that the physician cares for the well-being of his or her patients. Management and professional practices emphasize process and productivity pose a risk to that responsibility, potentially leading to disillusionment and loss of morale.

Resilience Training: No More is Needed or Desired

NAM — Mon, 22 Jul 2019 18:29:24 +0000

Published in Postgraduate Medical Journal (BMJ), the following is a critical response to Halliday et al.’s ‘Grit and burnout in UK doctors: a cross-sectional study across specialties and stages of training.’ David Smith argues that the inter-generational differences identified are a means of scapegoating the new generation of junior doctors for their lack of resilience and ‘grit.’ He emphasizes that resiliency training is not well-received and demands NHS Management implement more concrete action to address the critical issue of resident and physician well-being.