Higher Perceived Clinic Capacity to Address Patients' Social Needs Associated with Lower Burnout in Primary Care Providers

Olayiwola, J. Nwando; Willard-Grace, Rachel; Dubé, Kate; Hessler, Danielle; Shunk, Rebecca; Grumbach, Kevin; Gottlieb, Laura M.

doi:10.1353/hpu.2018.0028

Cited by 59 publications

(58 citation statements)

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“…Several recent studies have found that provider burnout is lower when providers perceive their healthcare organizations to have the capacity to address patients' social needs. 30,31 With provider burnout estimated to cost from $2.6 to $6.3 billion per year, reducing turnover could provide substantial economic benefits. 32 At the same time, requiring providers to screen and provide social needs referrals on a routine basis could also increase provider burnout by adding yet one more requirement to already full schedules.…”

Section: Reduced Provider Burnoutmentioning

confidence: 99%

Improving Social Needs Intervention Research: Key Questions for Advancing the Field

Fichtenberg

Alley

Mistry

2019

American Journal of Preventive Medicine

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Spurred by accumulated evidence documenting how social determinants of health shape health outcomes as well as the push for better value, the healthcare sector is embracing interventions that address patients' health-related social needs. An increasing number of healthcare organizations and payers are experimenting with strategies to identify needs and connect patients to resources that address identified needs with the goal of improving health outcomes, reducing avoidable utilization of costly health services, and improving health equity. Although many studies link social factors to health, relatively little published research exists about how the healthcare sector can effectively intervene to help identify and address social needs. This paper summarizes emerging evidence and identifies key areas where more research is needed to advance implementation and policy development. Although some healthcare-based social needs interventions have been shown to improve health and reduce avoidable utilization, important gaps remain in terms of comparative effectiveness and cost effectiveness of social needs intervention approaches. Additionally, the field would benefit from an increased understanding of mechanisms of action to maximize practitioners' ability to tailor interventions. More research is also needed to guard against unintended consequences and ensure these interventions reduce health inequities. Finally, implementation science research should identify supports and incentives for adoption of effective interventions. Focusing both public and private research efforts on these evidence gaps can help advance identification of interventions that maximize both health equity and healthcare value.

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Section: Reduced Provider Burnoutmentioning

confidence: 99%

Improving Social Needs Intervention Research: Key Questions for Advancing the Field

Fichtenberg

Alley

Mistry

2019

American Journal of Preventive Medicine

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“…Further work is therefore required to understand how best to support patients and professionals in this area, for it was also clear that our participants not only valued the possibility of more empathy and understanding from their health care professionals but could also imagine that this would get them access to practical support and appropriate advice. Interestingly, none talked about looking for support in gaining more access to nancial resources -the root cause of their food insecurity -and is something that we suspect could be a barrier on the part of health care professionals to raising the issue, who may feel powerless to do much about it [93]. This particular nding (the invisibility of nancial vulnerability within the health care consultation) challenges orthodox notions of selfmanagement support policy and practice within health care settings (in UK and internationally).…”

Section: Discussionmentioning

confidence: 99%

A qualitative investigation of lived experiences of long-term health condition management with people who are food insecure

Douglas

MacIver

Yuill

2020

Preprint

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Background: As more people are living with one or more chronic health conditions, supporting patients to become activated, self-managers of their conditions has become a key health policy focus both in the UK and internationally. There is also growing evidence in the UK that those with long term health conditions have an increased risk of being food insecure. While international evidence indicates that food insecurity adversely affects individual’s health condition management capability, little is known about how those so affected manage their condition(s) in this context. An investigation of lived experience of health condition management was undertaken with food insecure people living in north east Scotland. The study aimed to explore the challenges facing food insecure people in terms of, i. their self-care condition management practices, and ii. disclosing and discussing the experience of managing their condition with a health care professional, and iii. notions of the support they might wish to receive from them. Methods : Twenty in-depth interviews were conducted with individuals attending a food bank and food pantry in north east Scotland. Interview audio recordings were fully transcribed and thematically analysed.Results : Individuals reporting multiple physical and mental health conditions, took part in the study. Four main themes were identified i.e.: 1. food practices, trade-offs and compromises, that relate to economic constraints and lack of choice; 2. illness experiences and food as they relate to physical and mental ill-health; 3. (in)visibility of participants’ economic vulnerability within health care consultations; and 4. perceptions and expectations of the health care system.Conclusions : This study, the first of its kind in the UK, indicated that participants’ health condition management aspirations were undermined by the experience of food insecurity, and that their health care consultations in were, on the whole, devoid of discussions of those challenges. As such, the study indicated practical and ethical implications for health care policy, practice and research associated with the risk of intervention-generated health inequalities that were suggested by this study. Better understanding is needed about the impact of household food insecurity on existing ill health, wellbeing and health care use across the UK.

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“…Our study findings also help to explain other recent work linking burnout and capacity to address social needs. 22,[24][25][26] Having dedicated team members directly address social needs helped clinicians stay engaged and feel more connected with their patients, which is a major source of work-related satisfaction for clinicians. 39,40 The findings also highlight how structural challenges-including lack of reimbursement, inadequate integration between medical and social delivery systems, and insufficient nonclinical capacity to address social needs-presented key barriers to professional efficacy, an important component of burnout.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have demonstrated direct or potential links between clinician burnout and the ability to address patients' social needs. [22][23][24][25][26] One study showed that primary care clinicians reporting extreme stress were more likely to rate patients' social or financial issues as most relevant to patient complexity. 22 Lower satisfaction with resources for treating complex patients has been associated with more symptoms of burnout 23 ; conversely, practice preparedness to address social needs and ease of coordinating social services have been associated with greater clinician satisfaction.…”

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confidence: 99%

“…24 Two other studies also have shown that greater clinician perception of clinic capacity to address patients' social needs is significantly correlated with lower burnout. 25,26 Despite this growing body of work linking low resources for meeting patients' social needs and clinician burnout, we know little about pathways connecting the two. Our main objective for this study was to understand how primary care clinicians conceptualize the relationship between burnout and capacity to address patients' social needs.…”

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confidence: 99%

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Capacity to Address Social Needs Affects Primary Care Clinician Burnout

et al. 2019

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PURPOSE Primary care clinicians disproportionately report symptoms of burnout, threatening workforce sustainability and quality of care. Recent surveys report that these symptoms are greater when clinicians perceive fewer clinic resources to address patients' social needs. We undertook this study to better understand the relationship between burnout and clinic capacity to address social needs. METHODS We completed semistructured, in-person interviews and brief surveys with 29 primary care clinicians serving low-income populations. Interview and survey topics included burnout and clinic capacity to address social needs. We analyzed interviews using a modified grounded theory approach to qualitative research and used survey responses to contextualize our qualitative findings. RESULTS Four key themes emerged from the interview analyses: (1) burnout can affect how clinicians evaluate their clinic's resources to address social needs, with clinicians reporting high emotional exhaustion perceiving low efficacy even in when such resources are available; (2) unmet social needs affect practice by influencing clinic flow, treatment planning, and clinician emotional wellness; (3) social services embedded in primary care clinics buffer against burnout by increasing efficiency, restoring clinicians' medical roles, and improving morale; and (4) clinicians view clinic-level interventions to address patients' social needs as a necessary but insufficient strategy to address burnout. CONCLUSIONS Primary care clinicians described multiple pathways whereby increased clinic capacity to address patients' social needs mitigates burnout symptoms. These findings may inform burnout prevention strategies that strengthen the capacity to address patients' social needs in primary care clinical settings.

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Higher Perceived Clinic Capacity to Address Patients' Social Needs Associated with Lower Burnout in Primary Care Providers

Abstract: Provider perceptions of greater clinic capacity to address SN are significantly associated with lower burnout. Devoting organizational resources to address SN may reduce PCP burnout.

Cited by 59 publications

References 1 publication

Improving Social Needs Intervention Research: Key Questions for Advancing the Field

Improving Social Needs Intervention Research: Key Questions for Advancing the Field

A qualitative investigation of lived experiences of long-term health condition management with people who are food insecure

Capacity to Address Social Needs Affects Primary Care Clinician Burnout

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