Trends and Factors Associated With Physician Burnout at a Multispecialty Academic Faculty Practice Organization

Carmen, Marcela G. del; Herman, John B.; Rao, Sandhya K.; Hidrue, Michael K.; Ting, David; Lehrhoff, Sara R.; Lenz, Sarah; Heffernan, James; Ferris, Timothy G.

doi:10.1001/jamanetworkopen.2019.0554

Cited by 135 publications

(156 citation statements)

References 31 publications

(110 reference statements)

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“…[16][17][18][19] Furthermore, 'ticking boxes' diminishes physicians' and nurses' sense of autonomy, 20,21 and administrative tasks are seen as the leading cause of burnout and turnover among healthcare professionals. 6,20,22,23 In other words, the current number, efficacy and efficiency of quality measurements potentially threatens the quality of care by diminishing the joy in work of healthcare professionals. [24][25][26] Despite these concerns, the nature and consequences of this registration burden as perceived by healthcare professionals has received little empirical attention.…”

Section: Key Messagesmentioning

confidence: 99%

Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study

Zegers¹,

Veenstra

Gerritsen

et al. 2020

Int J Health Policy Manag

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Background: Quality indicators are registered to monitor and improve the quality of care. However, the number and effectiveness of quality indicators is under debate, and may influence the joy in work of physicians and nurses. Empirical data on the nature and consequences of the registration burden are lacking. The aim of this study was to identify and explore healthcare professionals’ perceived burden due to quality registrations in hospitals, and the effect of this burden on their joy in work. Methods: A mixed methods observational study, including participative observations, a survey and semi-structured interviews in two academic hospitals and one teaching hospital in the Netherlands. Study participants were 371 healthcare professionals from an intensive care unit (ICU), a haematology department and others involved in the care of elderly patients and patients with prostate or gastrointestinal cancer. Results: On average, healthcare professionals spend 52.3 minutes per working day on quality registrations. The average number of quality measures per department is 91, with 1380 underlying variables. Overall, 57% are primarily registered for accountability purposes, 19% for institutional governance and 25% for quality improvement objectives. Only 36% were perceived as useful for improving quality in everyday practice. Eight types of registration burden were identified, such as an excessive number of quality registrations, and the lack of usefulness for improving quality and inefficiencies in the registration process. The time healthcare professionals spent on quality registrations was not correlated with any measure of joy in work. Perceived unreasonable registrations were negatively associated with healthcare professionals’ joy in work (intrinsic motivation and autonomy). Healthcare professionals experienced quality registrations as diverting time from patient care and from actually improving quality. Conclusion: Registering fewer quality indicators, but more of what really matters to healthcare professionals, is key to increasing the effectiveness of registrations for quality improvement and governance. Also the efficiency of quality registrations should be increased through staffing and information and communications technology solutions to reduce the registration burden experienced by nurses and physicians.

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Section: Key Messagesmentioning

confidence: 99%

Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study

Zegers¹,

Veenstra

Gerritsen

et al. 2020

Int J Health Policy Manag

View full text Add to dashboard Cite

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“…A high physician turnover rate not only may lead to diminished productivity, low morale, and diminished quality of patient care but also poses a nancial burden. The costs of replacing a physician due to recruitment, onboarding, and lost patient care revenue equates to 2-3 times the physician's annual salary [10,12]. The turnover rate of our Institution's providers was extremely low at 5.6% in 2017 and decreased by 30% to 3.9% in 2019.…”

Section: Physician Turnover Ratementioning

confidence: 99%

“…and shorter life expectancy [4,8,10,13,14]. Physicians have a 5-fold increased risk of suicide compared to non-physicians, accounting for 400 suicides annually in the United States [8].…”

mentioning

confidence: 99%

Multidisciplinary Approach to Enhancing Provider Well-Being in a Metropolitan Medical Group in the United States

Shields

Jennings

Honaker

2020

Preprint

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Background: Physician burnout refers to depersonalization, emotional exhaustion, and a sense of lower personal accomplishment. Affecting approximately 50% of physicians in the United States, physician burnout negatively impacts both the physician and patient. Over a 3-year-period, this prospective study evaluated the multidisciplinary approach to decreasing provider burnout and improving provider well-being in our metropolitan community. Methods: A multidisciplinary Well-Being Task Force was established at our Institution in 2017 to assess the myriad factors that may play a role in provider burnout and offer solutions to mitigate the stressors that may lead to decreased provider well-being. Four multifaceted strategies were implemented: (1) provider engagement & growth; (2) workflow/office efficiencies; (3) relationship building; and (4) communication. Providers at our Institution took the Mayo Clinic’s well-being index survey on 3 occasions over 3 years. Their scores were compared to those of providers nationally at baseline and at 1 and 2 years after implementing organizational and individualized techniques to enhance provider well-being. Lower well-being index scores reflected better well-being. Results: The average overall well-being index scores of our Institution’s providers decreased from 1.76 at baseline to 1.32 2 years later compared to an increase in well-being index scores of physicians nationally (1.73 to 1.85). Both male and female providers’ average well-being index scores at our Institution decreased over the 3 years of this study, from 1.72 to 1.58 for males and 1.78 to 1.21 for females, while physicians’ scores nationally increased for both genders. The average well-being index scores were highest for providers at our Institution who graduated from medical school less than 5 years earlier (2.0) and who graduated 15-24 years earlier (2.3), whereas the average lowest scores were observed in providers who graduated ³ 25 years earlier (1.37). Obstetricians/gynecologists and internal medicine physicians had the highest average well-being index scores (2.48 and 2.4, respectively) compared to other medical specialties. The turnover rate of our Institution’s providers was 5.6% in 2017 and 3.9% in 2019, reflecting a 30% decrease. Conclusion: This study serves as a model to reduce provider burnout and enhance well-being through both organizational and individual interventions.

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“…Meaningful work (which I perceive as a surrogate for purpose) included patient care, teaching, research, and volunteering. 10 Human connections are a powerful component of joy. Connectivity can provide both purpose and better mental and physical health.…”

Section: Human Connections and Joymentioning

confidence: 99%

The 2019 Joseph W. St. Geme, Jr Leadership Award Address: Ubuntu: The Power of Social Connections

Stapleton

2019

Pediatrics

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Trends and Factors Associated With Physician Burnout at a Multispecialty Academic Faculty Practice Organization

Cited by 135 publications

References 31 publications

Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study

Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study

Multidisciplinary Approach to Enhancing Provider Well-Being in a Metropolitan Medical Group in the United States

The 2019 Joseph W. St. Geme, Jr Leadership Award Address: Ubuntu: The Power of Social Connections

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