Impact of Protected Sleep Period for Internal Medicine Interns on Overnight Call on Depression, Burnout, and Empathy

Shea, Judy A.; Bellini, Lisa M.; Dinges, David F.; Curtis, Meredith L.; Tao, Yuanyuan; Zhu, Jingsan; Small, Dylan S.; Basner, Mathias; Norton, Laurie; Novak, Cristina; Dine, C. Jessica; Rosen, Ilene M.; Volpp, Kevin G.

doi:10.4300/jgme-d-13-00241.1

Cited by 32 publications

(49 citation statements)

References 23 publications

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“…Many causes of burnout derive from organizational-and system-level factors, including electronic health records (EHRs (5), 33,47,52,54,57 Canada (2), 42,48 Egypt (1), 53 and multinational (2). 24,35 Study designs included randomized controlled trials (10), 23,28,29,37,39,40,42,45,48,51 prospective studies (5), 43,44,50,56,60 cross-sectional studies (7), 19,38,47,52,53,66,68 and other designs (4). 24,27,35,59 The included studies evaluated interventions among primary care physicians and residents (12) 31,63,66 and groups of physicians with specialty unspecified (7).…”

Section: Resultsmentioning

confidence: 99%

“…47 On the other hand, interns randomized to receive 5 hours of protected time to sleep while on call reported significantly lower levels of MBI-assessed emotional exhaustion and MBI-assessed depersonalization over 6 consecutive 4-week periods. 51 Similarly, surveys of junior doctors found that after 6 months of WTR compliance, those working schedules that required 7 consecutive nights experienced a greater accumulation of fatigue when compared with those limited to working just 3 or 4 nights in row. 52 A time-banking intervention for medical school faculty found that institutional recognition of time spent on additional activities, such as teaching, clinical service, and mentorship, improved job satisfaction (P¼.02).…”

Section: Teamworkmentioning

confidence: 99%

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Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review

DeChant

Acs

Rhee

et al. 2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

119

132

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To assess the impact of organization-directed workplace interventions on physician burnout, including stress or job satisfaction in all settings, we conducted a systematic review of the literature published from multiple databases. Manual searches of grey literature and bibliographies were also performed. Of the 633 identified citations, 50 met inclusion criteria. Four unique categories of organization-directed workplace interventions were identified. Teamwork involved initiatives to incorporate scribes or medical assistants into electronic health record (EHR) processes, expand team responsibilities, and improve communication among physicians. Time studies evaluated the impact of schedule adjustments, duty hour restrictions, and time-banking initiatives. Transitions referred to workflow changes such as process improvement initiatives or policy changes within the organization. Technology related to the implementation or improvement of EHRs. Of the 50 included studies, 35 (70.0%) reported interventions that successfully improved the 3 measures of physician burnout, job satisfaction, and/or stress. The largest benefits resulted from interventions that improved processes, promoted teambased care, and incorporated the use of scribes/medical assistants to complete EHR documentation and tasks. Implementation of EHR interventions to improve clinical workflows worsened burnout, but EHR improvements had positive effects. Time interventions had mixed effects on burnout. The results of our study suggest that organization-directed workplace interventions that improve processes, optimize EHRs, reduce clerical burden by the use of scribes, and implement team-based care can lessen physician burnout. Benefits of process changes can enhance physician resiliency, augment care provided by the team, and optimize the coordination and communication of patient care and health information.

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Section: Resultsmentioning

confidence: 99%

Section: Teamworkmentioning

confidence: 99%

Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review

DeChant

Acs

Rhee

et al. 2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

119

132

View full text Add to dashboard Cite

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“…9,10 For 3 high-quality RCTs, as judged by the Jadad scale, protected sleep periods 18 and communication and stress management 8 had no effect on burnout rates. Self-care workshops resulted in a decrease in the depersonalization component of burnout.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 14 observational studies that were assessed using the NOS (provided as online supplemental material), 2 were rated high quality, 12,13 and 7 were rated as being of moderate quality. 3,9,14,15,17,21,24 Of the 5 RCTs that were assessed using the Jadad scale (TABLE 1), 3 were rated high quality 8,18,19 (score ! 3), and the remaining 2 were rated to be of moderate quality.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review

Busireddy

Miller

Ellison

et al. 2017

Journal of Graduate Medical Education

229

214

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“…Sin embargo, se han reportado diversos problemas en el internado que podrían dificultar el aprendizaje y la realización de procedimientos por parte del interno, como sobrecarga laboral (7,8) , gran cantidad de trabajo administrativo (papeleo) (9,10) , inadecuada docencia, falta de supervisión de los procedimientos realizados (2) , falta de oportunidades para realizar ciertos procedimientos (11) , entre otros.…”

Section: Introductionunclassified

Percepción de médicos de una universidad de Lima sobre su capacitación en procedimientos médicos durante el internado

Taype-Rondán¹,

Rengifo²,

Arizabal³

et al. 2016

An Fac med

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ResumenObjetivos. Evaluar la percepción de médicos recién egresados sobre su capacitación en procedimientos médicos durante el internado, y determinar los factores asociados a recibir una adecuada capacitación en un mayor número de procedimientos, en una universidad de Lima, Perú. Diseño. Estudio observacional, transversal y analítico. Institución. Universidad de San Martín de Porres, Lima, Perú. Participantes. Médicos egresados. Métodos. Estudio tipo encuesta realizado en médicos egresados de una universidad privada de Lima, Perú, que realizaron el internado médico durante el año 2014. Se utilizó la red social Facebook para ubicar a los participantes, se obtuvo el consentimiento informado y se envió una encuesta autoaplicada con variables sociodemográficas y referentes a su internado médico. Principales medidas de resultados. Percepción sobre su capacitación en procedimientos médicos durante el internado. Resultados. Se analizaron 117 encuestas. El número de horas laboradas por día fue en promedio 10,0±1,8, la frecuencia de carga laboral excesiva y de 'papeleo excesivo' en al menos una rotación fueron 80,3% y 84,6%, respectivamente. Pocos encuestados recibieron durante su internado una adecuada capacitación en colocación de inyectables (53,9%), reducción de fracturas (28,2%) y atención de partos vaginales verticales (27,4%). Haber percibido una adecuada capacitación en más de 20 procedimientos se asoció a considerar una adecuada docencia en tres o cuatro rotaciones (RP=2,55, IC95%=1,36 a 4,76) y laborar en promedio 9 horas y 30 minutos a 10 horas y 15 minutos diarios en comparación con laborar menos horas diarias (RP=1,91, IC95%=1,01 a 3,64). Conclusiones. El exceso de carga laboral y el papeleo, así como una jornada laboral reducida, están asociados a una menor cantidad de procedimientos médicos en los que el interno se perciba adecuadamente capacitado. Es necesario implementar estrategias para mejorar la docencia en el internado. Palabras clave. Educación Médica; Formación de Recursos Humanos; Internado y Residencia. Abstract Objectives. To evaluate the perception of recently graduated physicians on their training in medical procedures during internship, and to determine factors associated to adequate training in a greater number of procedures at a university in Lima, Peru. Design. Observational, cross-sectional, analytical study. Setting. Universidad de San Martín de Porres, Lima, Peru. Participants. Recently graduated physicians. Methods. Survey study in medical graduates from a private university in Lima, Peru, who finished medical internship in 2014. Facebook social network was used to locate participants. Informed consent was obtained and a self-report survey was sent to collect sociodemographic characteristics and perceptions on their medical internship. Main outcome measures. Perception on medical procedures training during internship. Results. One hundred seventeen surveys were analyzed. The number of hours worked per day was on average 10.0 ± 1.8, the frequency of excessive workload and "excessive pa...

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Impact of Protected Sleep Period for Internal Medicine Interns on Overnight Call on Depression, Burnout, and Empathy

Abstract: Background Patient safety and sleep experts advocate a protected sleep period for residents.

Cited by 32 publications

References 23 publications

Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review

Effect of Organization-Directed Workplace Interventions on Physician Burnout: A Systematic Review

Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review

Percepción de médicos de una universidad de Lima sobre su capacitación en procedimientos médicos durante el internado

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