Intervention to Promote Physician Well-being, Job Satisfaction, and Professionalism

West, Colin P.; Dyrbye, Liselotte N.; Rabatin, Jeff T.; Call, Tim G.; Davidson, John; Multari, Adamarie; Romanski, Susan A.; Hellyer, Joan M. Henriksen; Sloan, Jeff A.; Shanafelt, Tait D.

doi:10.1001/jamainternmed.2013.14387

Cited by 567 publications

(455 citation statements)

References 30 publications

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“…There is emerging literature about interventions that individuals can undertake to better combat the tendency to burn out. 24,25 Our study complements this work by showing that organizational change may also lead to reduced stress and improved clinician outcomes. Our most powerful intervention was workflow modification, such as reassigning clinic staff work and changing call schedules.…”

Section: Discussionsupporting

confidence: 63%

A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study

et al. 2015

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BACKGROUND: Work conditions in primary care are associated with physician burnout and lower quality of care. OBJECTIVE: We aimed to assess if improvements in work conditions improve clinician stress and burnout. SUBJECTS: Primary care clinicians at 34 clinics in the upper Midwest and New York City participated in the study. STUDY DESIGN: This was a cluster randomized controlled trial. MEASURES: Work conditions, such as time pressure, workplace chaos, and work control, as well as clinician outcomes, were measured at baseline and at 12-18 months. A brief worklife and work conditions summary measure was provided to staff and clinicians at intervention sites. INTERVENTIONS: Diverse interventions were grouped into three categories: 1) improved communication; 2) changes in workflow, and 3) targeted quality improvement (QI) projects. ANALYSIS: Multilevel regressions assessed impact of worklife data and interventions on clinician outcomes. A multilevel analysis then looked at clinicians whose outcome scores improved and determined types of interventions associated with improvement. RESULTS: Of 166 clinicians, 135 (81.3 %) completed the study. While there was no group treatment effect of baseline data on clinician outcomes, more intervention clinicians showed improvements in burnout (21.8 % vs 7.1 % less burned out, p=0.01) and satisfaction (23.1 % vs 10.0 % more satisfied, p=0.04). Burnout was more likely to improve with workflow interventions [Odds Ratio (OR) of improvement in burnout 5.9, p=0.02], and with targeted QI projects than in controls (OR 4.8, p=0.02). Interventions in communication or workflow led to greater improvements in clinician satisfaction (OR 3.1, p=0.04), and showed a trend toward greater improvement in intention to leave (OR 4.2, p=0.06). LIMITATIONS:We used heterogeneous intervention types, and were uncertain how well interventions were instituted. CONCLUSIONS: Organizations may be able to improve burnout, dissatisfaction and retention by addressing communication and workflow, and initiating QI projects targeting clinician concerns.KEY WORDS: burnout; primary care; quality improvement; work conditions.

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Section: Discussionsupporting

confidence: 63%

A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study

et al. 2015

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“…While our design does not allow for establishing causality, it is plausible that the type of doctoring most valued by patients, and most encouraged by the medical education community, may come at a cost to the well-being of the resident physician. If future studies establish this causal relationship, we might more closely monitor our most dedicated trainees and utilize targeted interventions to enhance their well-being 33 and resilience. 34 Several limitations should be considered.…”

Section: Discussionmentioning

confidence: 99%

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic

et al. 2015

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“…Although this was not aimed at education specifically, it could be a helpful intervention for health care professionals overall as it contains elements of both job resources (i.e. promoting collegiality) as well as personal resources (mindfulness and reflection) (West et al 2014).…”

Section: Interventions Aimed At Increasing Personal Resourcesmentioning

confidence: 99%

Work engagement in health professions education

et al. 2017

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Work engagement deserves more attention in health professions education because of its positive relations with personal well-being and performance at work. For health professions education, these outcomes have been studied on various levels. Consider engaged clinical teachers, who are seen as better clinical teachers; consider engaged residents, who report committing fewer medical errors than less engaged peers. Many topics in health professions education can benefit from explicitly including work engagement as an intended outcome such as faculty development programs, feedback provision and teacher recognition. In addition, interventions aimed at strengthening resources could provide teachers with a solid foundation for well-being and performance in all their work roles. Work engagement is conceptually linked to burnout. An important model that underlies both burnout and work engagement literature is the job demands-resources (JD-R) model. This model can be used to describe relationships between work characteristics, personal characteristics and well-being and performance at work. We explain how using this model helps identifying aspects of teaching that foster well-being and how it paves the way for interventions which aim to increase teacher's well-being and performance.

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Intervention to Promote Physician Well-being, Job Satisfaction, and Professionalism

Cited by 567 publications

References 30 publications

A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study

A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic

Work engagement in health professions education

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