Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience

Swensen, Stephen J.; Kabcenell, Andrea; Shanafelt, Tait D.

doi:10.1097/00115514-201603000-00008

Cited by 154 publications

(168 citation statements)

References 41 publications

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“…(Association, ; Erickson, Rockwern, Koltov, & McLean, ; Woolhandler & Himmelstein, ) Documentation could be further assisted by scribes or shared with clinical teammates (team‐based documentation and in‐baskets, nonphysician order entry). (Sinsky et al, ) Team‐based patient care is conducted with allied health professionals via “teamlets” or through the expanded roles of medical assistants who participate throughout the patient encounter rooming, scribing, preparing discharge instructions, and coaching patients (Chapman & Blash, ; LaVela & Hill, ; Oostra, ; Swensen et al, ; Willard‐Grace et al, ). Our findings and those of others suggest efforts are required for EMRs to better support physician's work and diminish burnout (Babbott et al, ; Shanafelt, Dyrbye, et al, ); policies regarding scope of practice and nonphysician order entry need review to facilitate team‐based care.…”

Section: Discussionmentioning

confidence: 99%

Cross‐sectional survey of workplace stressors associated with physician burnout measured by the Mini‐Z and the Maslach Burnout Inventory

Olson¹,

Sinsky

Rinne³

et al. 2019

Stress and Health

149

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Rising physician burnout has adverse effects on healthcare. This study aimed to identify remediable stressors associated with burnout using the 10‐item Mini‐Z and the Maslach Burnout Inventory (MBI), and to compare performance of the Mini‐Z's single‐item burnout metric against the 22‐item MBI. Surveys were emailed to 4,118 clinicians affiliated with an academic health system; 1,252 clicked the link, and 557 responded (completion rate 44%). Four hundred seventy‐five practicing physicians were included: academic faculty (372), hospital employed (52), and private practitioners (81). Prevalence of burnout via the MBI was 56.6%. Predictors of burnout were poor control over workload [OR = 8.24, 95% CI 4.(81, 14.11)], inefficient teamwork [OR = 7.61, 95% (CI 3.28, 17.67)], insufficient documentation time [OR = 5.83, 95% (CI 3.35, 10.15)], hectic‐chaotic work atmosphere [OR = 3.49, 95% (CI 2.12, 5.74)], lack of value‐alignment with leadership [OR = 3.27, 95% (CI 2.12, 5.74)], and excessive electronic medical record time at home [OR = 1.99, 95% CI (1.21, 3.27)]. Academic faculty experienced more burnout than private practitioners (59.9% vs. 42.0%, p = 0.013). Odds of burnout associated with stressors were generally concordant via Mini‐Z's burnout metric versus the MBI. The Mini‐Z is a brief, valid method to identify stressors associated with burnout and guide interventions.

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Section: Discussionmentioning

confidence: 99%

Cross‐sectional survey of workplace stressors associated with physician burnout measured by the Mini‐Z and the Maslach Burnout Inventory

Olson¹,

Sinsky

Rinne³

et al. 2019

Stress and Health

149

View full text Add to dashboard Cite

show abstract

“…HCIA programs tended to work best when they appealed to physicians' intrinsic motivations (Conrad et al. ; Conrad and Christianson ; Swensen, Kabcenell, and Shanafelt ) such as prioritizing high‐quality and efficient service provision (Reinertsen et al. ; Punke ).…”

Section: Discussionmentioning

confidence: 99%

“…In line with prior findings, we found that use of financial rewards played an insubstantial role in engaging physicians. HCIA programs tended to work best when they appealed to physicians' intrinsic motivations (Conrad et al 2002;Conrad and Christianson 2004;Swensen, Kabcenell, and Shanafelt 2015) such as prioritizing high-quality and efficient service provision (Reinertsen et al 2007;Punke 2013). The tailored strategies highlighted in this analysis may offer alternative solutions to programs that lack financial resources to provide direct incentives.…”

Section: Discussionmentioning

confidence: 99%

“…Successful engagement strategies have included enhancing administrative support, creating physician leaders, and educating physicians on programmatic goals (Sears ; Bleser et al. ; Govender ; Swensen, Kabcenell, and Shanafelt ). Financial incentives (e.g., capitation payments, production‐based compensation) have not proven particularly effective (Kralewski et al.…”

Section: Introductionmentioning

confidence: 99%

“…Sutaria 2013); support of hospital leadership (Spaulding, Gamm, and Menser 2014), administration (Coulam et al 2016), and physician supervisors ; relationships with local organizations; and market structure (Rodriguez et al 2009). Successful engagement strategies have included enhancing administrative support, creating physician leaders, and educating physicians on programmatic goals (Sears 2011;Bleser et al 2014;Govender 2015;Swensen, Kabcenell, and Shanafelt 2015). Financial incentives (e.g., capitation payments, production-based compensation) have not proven particularly effective (Kralewski et al 1996;Conrad et al 1998;Reschovsky, Hadley, and Landon 2006;Scott et al 2011).…”

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confidence: 99%

See 2 more Smart Citations

Physician Engagement Strategies in Care Coordination: Findings from the Centers for Medicare & Medicaid Services’ Health Care Innovation Awards Program

Skillman

Cross‐Barnet

Singer

et al. 2016

Health Services Research

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Controlled Interventions to Reduce Burnout in Physicians

et al. 2017

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IMPORTANCE: Burnout is prevalent in physicians and can have a negative influence on performance, career continuation and patient care. Existing evidence does not allow clear recommendations for the management of burnout in physicians. OBJECTIVE: To evaluate the effectiveness of interventions to reduce burnout in physicians. We also examined whether different types of interventions (physician-directed or organization-directed interventions), physician characteristics (length of experience) and healthcare setting characteristics (primary or secondary care) were associated with improved effects. DATA SOURCES: Medline, Embase, PsycINFO, Cinahl, and Central, were searched from inception to May 2016. The reference lists of eligible studies and other relevant systematic reviews were hand-searched. STUDY SELECTION: Randomized controlled trials and controlled before-after studies of interventions targeting burnout in physicians. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed the risk of bias. The main meta-analysis was followed by a number of pre-specified subgroup and sensitivity analyses. All analyses were performed using random-effects models and heterogeneity was quantified using I 2. MAIN OUTCOME AND MEASURES: The core outcome was burnout scores focused on emotional exhaustion, reported as standardized mean differences and their 95% confidence intervals. RESULTS: Twenty independent comparisons from 19 studies were included in the metaanalysis (n=1,550 physicians). Interventions were associated with small significant reductions in burnout (SMD=-0.29, 95% CI=-0.42 to-0.16; equal to a drop of 3-points on the emotional exhaustion domain of the Maslach Burnout Inventory above change in the controls). Subgroup analyses suggested significantly improved effects for organization-5 directed interventions (SMD=-0.45, 95% CI=-0.62 to-0.28) compared to physician-directed interventions (SMD=-0.18, 95% CI=-0.32 to-0.03). Interventions delivered in experienced physicians and in primary care were associated with higher effects compared to interventions delivered in inexperienced physicians and in secondary care, but these differences were not significant. The results were not influenced by the risk of bias ratings. CONCLUSION: Evidence from this meta-analysis suggests that current intervention programs for burnout in physicians are associated with small benefits which may be boosted by adoption of organization-directed approaches. This finding provides support for the view that burnout is a problem of the whole healthcare organization, rather than individuals.

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Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience

Cited by 154 publications

References 41 publications

Cross‐sectional survey of workplace stressors associated with physician burnout measured by the Mini‐Z and the Maslach Burnout Inventory

Cross‐sectional survey of workplace stressors associated with physician burnout measured by the Mini‐Z and the Maslach Burnout Inventory

Physician Engagement Strategies in Care Coordination: Findings from the Centers for Medicare & Medicaid Services’ Health Care Innovation Awards Program

Controlled Interventions to Reduce Burnout in Physicians

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