The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members

Helfrich, Christian D.; Simonetti, Joseph A.; Clinton, Walter L.; Wood, G. Blake; Taylor, Larry E.; Schectman, Gordon; Stark, Richard; Rubenstein, Lisa V.; Fihn, Stephan D.; Nelson, Karin M.

doi:10.1007/s11606-017-4011-4

Cited by 111 publications

(113 citation statements)

References 37 publications

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“…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. Stable adequate staffing also reduces turnover, improves satisfaction, and reduces burnout (Helfrich et al, ).…”

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

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“…26 Developing functional team relationships that allow for effective team-based task delegation requires a fully staffed PACT team and adequate time spent working together to learn how to maximize each team member's skill set. Without well-staffed, trained, and stable teams, the complex job of efficiently sharing work among a primary care teamlet may be impossible.…”

Section: Discussionmentioning

confidence: 99%

“…This question has been validated previously against the Emotional Exhaustion Subscale of the Maslach Burnout Inven- tory. 26,33,35 Consistent with previous analyses, a score Ն3 was considered burnout. …”

Section: Burnoutmentioning

confidence: 96%

“…16,17 Burnout is common among primary care providers (PCPs) 18,19 and primary care nurses 20 , with potentially negative implications for patient satisfaction 21,22 , patient safety 18,23,24 , and employee turnover. 25 Clinical workload, unstable and inadequate staffing 26 , and performing tasks that do not take advantage of a team members' skills 27 are associated with increased burnout. By contrast, perception that a team culture exists is greater 28 and more sharing of clinical and clerical tasks 29 , are associated with lower burnout among PCPs and staff.…”

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confidence: 99%

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Task Delegation and Burnout Trade-offs Among Primary Care Providers and Nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs)

et al. 2018

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Purpose: Appropriate delegation of clinical tasks from primary care providers (PCPs) to other team members may reduce employee burnout in primary care. However, (1) the extent to which delegation occurs within multidisciplinary teams, (2) factors associated with greater delegation, and (3) whether delegation is associated with burnout are all unknown.Methods: We performed a national cross-sectional survey of Veterans Affairs (VA) PCP-nurse dyads in Department of VA primary care clinics, 4 years into the VA's patient-centered medical home initiative. PCPs reported the extent to which they relied on other team members to complete 15 common primary care tasks; paired nurses reported how much they were relied on to complete the same tasks. A composite score of task delegation/reliance was developed by taking the average of the responses to the 15 questions. We performed multivariable regression to explore predictors of task delegation and burnout. Results: Among 777 PCP-nurse dyads, PCPs reported delegating tasks less than nurses reported being relied on (PCP mean

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“…In this issue of JGIM, Helfrich et al undertake the important task of trying to understand factors associated with primary care burnout at the VA. 2 The first key finding from their analysis is that burnout is rampant, reported by an alarming 41% of VA primary care staff. Sadly, this is consistent with prior studies in other health systems.…”

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confidence: 99%

Capsule Commentary on Helfrich et al., The association of team-specific workload and staffing with odds of burnout among VA primary care team members

Hochman¹

2017

J GEN INTERN MED

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The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members

Abstract: Complete team staffing, turnover among team members, and panel overcapacity had strong, cumulative associations with burnout. Further research is needed to understand whether improvements in these factors would lower burnout.

Cited by 111 publications

References 37 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

Task Delegation and Burnout Trade-offs Among Primary Care Providers and Nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs)

Capsule Commentary on Helfrich et al., The association of team-specific workload and staffing with odds of burnout among VA primary care team members

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