Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians

Abstract

The views expressed here are solely those of the authors and do not necessarily represent the position of the Veterans Health Administration, United States government, or authors' respective academic institutions.

The Impact of the COVID-19 Pandemic on Mental Health, Occupational Functioning, and Professional Retention Among Health Care Workers and First Responders

“…4), both by decreasing the volume of COVID-19 impacted care individuals are providing and the associated personal risk they experience while doing so (direct factors) and by changing the context in which this care is being provided (contextual factors). Although it is important to prospectively test the impact of such interventions, existing evidence supports the efficacy of systematic approaches to identifying and addressing factors that unnecessarily increase workload, while supporting health care workers' control and flexibility, meaning in work, and workplace community 5,[44][45][46] . Identifying and rectifying barriers to communication and transparency within a workplace, providing regular and effective feedback to leadership, and increasing the frontline worker input are often critical intervention components 5,[47][48][49] .…”

Changes in Burnout and Moral Distress Among Veterans Health Administration (VA) Physicians Before and During the COVID-19 Pandemic

“…Organizational satisfaction and psychological safety have been previously linked to lower burnout in VA- 5 and non-VA 56 primary care. A small early pandemic study of two VA primary care clinics also showed the association between positive perceptions of the working environment across multiple dimensions (eg, community and fairness) and lower burnout.…”

“…30 These demands and resources include literal job demands and resources, like workload or staffing, as well as psychological or environmental demands and resources, like interpersonal conflict or a positive organizational culture. 31 Previous work in VA among behavioral healthcare providers and primary care physicians has shown that reasonable workload, 3,5 adequate resources, 3 and organizational satisfaction 5 are all linked to lower burnout. During the COVID-19 pandemic, healthcare staff were challenged with limited resources, such as a lack of personal protective equipment, shifting workloads, and concern for personal and loved one's safety.…”

“…2 Other national studies of VA healthcare found similarly high burnout rates: 31%-38% of behavioral health providers were burned out from 2015 to 2018 3 and 48%-66% of primary care providers were burned out from 2013 to 2019. [4][5][6] New workplace conditions imposed by COVID-19 (ie, limited resources and treatment, extended shifts, pandemic-induced stress) may have taken a psychological and emotional toll on physicians. The pandemic has increased work-related stressors, with some studies showing increased burnout and mental health issues, [7][8][9] particularly in higher-risk settings, such as the emergency department, intensive care units, and COVID-19 wards.…”

A peer veteran approach to the caring letters suicide prevention program: Preliminary data.

“…Signs of burnout are reported among more than half of physicians, one third of nursing staff (Reith, 2018), and up to two thirds of mental health workers (Morse et al, 2012). Burnout is also found among VHA providers; one study that examined burnout across all VHA regions (i.e., Veterans Integrated Service Networks) reported that nearly two thirds of primary care providers report some level of emotional exhaustion each week (Sterling et al, 2022). Therefore, there may be an opportunity in the future to consider reshaping existing VA Caring Contact programs (Landes et al, 2021; Reger, Jegley, et al, 2022) to harnesses the passion of veteran advocacy groups (e.g., VSOs), increase suicide prevention, tailor Caring Letters to unique aspects of veteran culture (e.g., peer support), and provide benefits to volunteer letter writers, all without increasing health care professional workload.…”