{"id":35,"date":"2017-12-04T19:48:10","date_gmt":"2017-12-04T19:48:10","guid":{"rendered":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//?page_id=35"},"modified":"2018-04-10T10:56:33","modified_gmt":"2018-04-10T10:56:33","slug":"practice-environment","status":"publish","type":"page","link":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//causes/clinicianwellbeing/wp-json/wp/v2/pages/35//practice-environment/clinicianwellbeing/wp-json/wp/v2/pages/35//","title":{"rendered":"Practice Environment"},"content":{"rendered":"

Burnout is driven largely by external factors outside the control of an individual clinician, including physical and social characteristics of the settings where care is provided./clinicianwellbeing/wp-json/wp/v2/pages/35/n

Electronic Health Records and Documentation Requirements/clinicianwellbeing/wp-json/wp/v2/pages/35/n

The rise of electronic health record (EHRs) has transformed clinicians/clinicianwellbeing/wp-json/wp/v2/pages/35/u2019 daily routines and fundamentally altered the practice environment. In 2008, only about 15% of care settings used EHRs. By 2012, the number had rocketed to over 70%. While EHRs have changed much about the way medicine is practiced, EHRs do not necessarily reduce administrative burden. Today, physicians, residents, and nurses report spending half their time/clinicianwellbeing/wp-json/wp/v2/pages/35/u2014or more/clinicianwellbeing/wp-json/wp/v2/pages/35/u2014using EHR systems to document care, order tests, review results, and communicate with colleagues or patients. As a result, clinicians experience less flexibility and control over their workday and increased social isolation in favor of screen time. EHR systems may also increase clinicians/clinicianwellbeing/wp-json/wp/v2/pages/35/u2019 workload, as time pressures during the workday prompt clinicians to save data entry tasks for after hours./clinicianwellbeing/wp-json/wp/v2/pages/35/n

In addition, the linkage of documentation to financial reimbursement requires clinicians to record information that is necessary for billing purposes but often irrelevant to patient care. These documentation requirements are complex and time-consuming, leading to the proliferation of redundant email reminders, templates, checklists, attestation statements and other boilerplate text that interfere with workflow and may erode clinicians/clinicianwellbeing/wp-json/wp/v2/pages/35/u2019 sense of purpose and autonomy. For more on documentation requirements, see Rules and Regulations./clinicianwellbeing/wp-json/wp/v2/pages/35/n

/clinicianwellbeing/wp-json/wp/v2/pages/35/"/clinicianwellbeing/wp-json/wp/v2/pages/35/"/clinicianwellbeing/wp-json/wp/v2/pages/35/n

Perhaps most importantly, the significant clerical burden imposed by EHRs and documentation requirements leads to less time spent with patients /clinicianwellbeing/wp-json/wp/v2/pages/35/u2013 the part of the job clinicians value most. Studies have shown that the less time clinicians spend on work they find meaningful, the more likely they are to experience burnout./clinicianwellbeing/wp-json/wp/v2/pages/35/n

Teamwork and Professional Relationships/clinicianwellbeing/wp-json/wp/v2/pages/35/n

Effective interprofessional teamwork is the bedrock of high-quality patient care, and it is also an essential foundation for clinician well-being. One model at a Wisconsin health organization has leveraged teams with carefully constructed ratios of physicians, nurses, and medical assistants or licensed practical nurses to reduce clerical burden and strengthen working relationships. Elements of functional teamwork include diversity and inclusion; communication; respect, support, and trust among peers; fair and effective allocation of tasks, resources, and opportunity; and transparency, accountability, and recognition of achievements. When these elements are absent or inadequate, burnout risk may increase./clinicianwellbeing/wp-json/wp/v2/pages/35/n

Physicians and nurses who are dissatisfied with the quality of teamwork in their workplace are more likely to experience emotional exhaustion, a key symptom of burnout. Emotional exhaustion, in turn, diminishes clinicians/clinicianwellbeing/wp-json/wp/v2/pages/35/u2019 engagement in teamwork, resulting in a destructive cycle. Nurses who leave the profession cite /clinicianwellbeing/wp-json/wp/v2/pages/35/u201cincivility, lack of professional encouragement, lack of appreciation from supervisors, and a diminished sense of value within the organization/clinicianwellbeing/wp-json/wp/v2/pages/35/u201d as key factors contributing to turnover, another important indicator of burnout./clinicianwellbeing/wp-json/wp/v2/pages/35/n

/clinicianwellbeing/wp-json/wp/v2/pages/35/"/clinicianwellbeing/wp-json/wp/v2/pages/35/"/clinicianwellbeing/wp-json/wp/v2/pages/35/n

For clinicians from minority or underrepresented groups, peer support and mentoring may be of particular importance. Within academic medicine, dedicated faculty development programs and peer support networks have been shown to increase retention and advancement rates for minority faculty; however, few such programs exist./clinicianwellbeing/wp-json/wp/v2/pages/35/n

For more on the importance of diversity and inclusion, see Organizational Factors. For information about mentoring as a resource for medical students, see Learning Environment./clinicianwellbeing/wp-json/wp/v2/pages/35/n

 /clinicianwellbeing/wp-json/wp/v2/pages/35/n","protected":false},"excerpt":{"rendered":"

Burnout is driven largely by external factors outside the control of an individual clinician, including physical and social characteristics of the settings where care is provided. Electronic Health Records and Documentation Requirements The rise of electronic health record (EHRs) has transformed clinicians/clinicianwellbeing/wp-json/wp/v2/pages/35/u2019 daily routines and fundamentally altered the practice environment. In 2008, only about 15% […]/clinicianwellbeing/wp-json/wp/v2/pages/35/n","protected":false},"author":35,"featured_media":0,"parent":11,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"page-topic.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-35","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//wp-json/clinicianwellbeing/wp-json/wp/v2/pages/35//wp/clinicianwellbeing/wp-json/wp/v2/pages/35//v2/clinicianwellbeing/wp-json/wp/v2/pages/35//pages/clinicianwellbeing/wp-json/wp/v2/pages/35//35","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//wp-json/clinicianwellbeing/wp-json/wp/v2/pages/35//wp/clinicianwellbeing/wp-json/wp/v2/pages/35//v2/clinicianwellbeing/wp-json/wp/v2/pages/35//pages"}],"about":[{"href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//wp-json/clinicianwellbeing/wp-json/wp/v2/pages/35//wp/clinicianwellbeing/wp-json/wp/v2/pages/35//v2/clinicianwellbeing/wp-json/wp/v2/pages/35//types/clinicianwellbeing/wp-json/wp/v2/pages/35//page"}],"author":[{"embeddable":true,"href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//wp-json/clinicianwellbeing/wp-json/wp/v2/pages/35//wp/clinicianwellbeing/wp-json/wp/v2/pages/35//v2/clinicianwellbeing/wp-json/wp/v2/pages/35//users/clinicianwellbeing/wp-json/wp/v2/pages/35//35"}],"replies":[{"embeddable":true,"href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//wp-json/clinicianwellbeing/wp-json/wp/v2/pages/35//wp/clinicianwellbeing/wp-json/wp/v2/pages/35//v2/clinicianwellbeing/wp-json/wp/v2/pages/35//comments?post=35"}],"version-history":[{"count":0,"href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//wp-json/clinicianwellbeing/wp-json/wp/v2/pages/35//wp/clinicianwellbeing/wp-json/wp/v2/pages/35//v2/clinicianwellbeing/wp-json/wp/v2/pages/35//pages/clinicianwellbeing/wp-json/wp/v2/pages/35//35/clinicianwellbeing/wp-json/wp/v2/pages/35//revisions"}],"up":[{"embeddable":true,"href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//wp-json/clinicianwellbeing/wp-json/wp/v2/pages/35//wp/clinicianwellbeing/wp-json/wp/v2/pages/35//v2/clinicianwellbeing/wp-json/wp/v2/pages/35//pages/clinicianwellbeing/wp-json/wp/v2/pages/35//11"}],"wp:attachment":[{"href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//nam.edu/clinicianwellbeing/wp-json/wp/v2/pages/35//clinicianwellbeing/clinicianwellbeing/wp-json/wp/v2/pages/35//wp-json/clinicianwellbeing/wp-json/wp/v2/pages/35//wp/clinicianwellbeing/wp-json/wp/v2/pages/35//v2/clinicianwellbeing/wp-json/wp/v2/pages/35//media?parent=35"}],"curies":[{"name":"wp","href":"https:/clinicianwellbeing/wp-json/wp/v2/pages/35///clinicianwellbeing/wp-json/wp/v2/pages/35//api.w.org/clinicianwellbeing/wp-json/wp/v2/pages/35//{rel}","templated":true}]}}