Validation of a single‐item measure of burnout against the Maslach Burnout Inventory among physicians

Rohland, Barbara M.; Kruse, Gina; Rohrer, James E.

doi:10.1002/smi.1002

Cited by 399 publications

(358 citation statements)

References 10 publications

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“…The single-item burnout measure has demonstrated very good correlations with the emotional exhaustion scale of the Maslach Burnout Inventory. 7 Mini Z results for the ACLGIM survey were portrayed as Bpercent of faculty burned out,^or Bpercent highly stressed,^by coalescing the high or low scores on each scale for all clinicians within the division (see Online Appendix for scale and scoring). A demographic section allowed respondents to self-report ambulatory versus hospital-based care, years in practice, gender, and race/ ethnicity.…”

Section: Methodsmentioning

confidence: 99%

Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey

et al. 2016

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BACKGROUND: General internal medicine (GIM) careers are increasingly viewed as challenging and unsustainable. OBJECTIVE: We aimed to assess academic GIM worklife and determine remediable predictors of stress and burnout. DESIGN: We conducted an email survey. PARTICIPANTS: Physicians, nurse practitioners, and physician assistants in 15 GIM divisions participated. MAIN MEASURES: A ten-item survey queried stress, burnout, and work conditions such as electronic medical record (EMR) challenges. An open-ended question assessed stressors and solutions. Results were categorized into burnout, high stress, high control, chaos, good teamwork, high values alignment, documentation time pressure, and excessive home EMR use. Frequencies were determined for national data, Veterans Affairs (VA) versus civilian populations, and hospitalist versus ambulatory roles. A General Linear Mixed Model (GLMM) evaluated associations with burnout. A formal content analysis was performed for open-ended question responses. KEY RESULTS: Of 1235 clinicians sampled, 579 responded (47 %). High stress was present in 67 %, with 38 % burned out (burnout range 10-56 % by division). Half of respondents had low work control, 60 % reported high documentation time pressure, half described too much home EMR time, and most reported very busy or chaotic workplaces. Two-thirds felt aligned with departmental leaders' values, and three-quarters were satisfied with teamwork. Burnout was associated with high stress, low work control, and low values alignment with leaders (all p < 0.001). The 45 VA faculty had less burnout than civilian counterparts (17 % vs. 40 %, p < 0.05). Hospitalists described better teamwork than ambulatory clinicians and fewer hospitalists noted documentation time pressure (both p < 0.001). Key themes from the qualitative analysis were short visits, insufficient support staff, a Relative Value Unit mentality, documentation time pressure, and undervaluing education. CONCLUSIONS:While GIM divisions overall demonstrate high stress and burnout, division rates vary widely. Sustainability efforts within GIM could focus on visit length, staff support, schedule control, clinic chaos, and EMR stress.

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Section: Methodsmentioning

confidence: 99%

Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey

et al. 2016

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“…4,5 Managers were questioned about clinic structure (rooms, staffing), policies, finances and procedures. Clinicians were questioned about stress, 15 burnout (a fiveitem scale, focusing primarily on emotional exhaustion, with a score of 3 or higher indicating burnout, 16,17 intent to leave in 2 years, and satisfaction. 4 They also provided perceptions of work conditions, including time pressure during visits, work control, emphasis on work home balance, chaotic environments, and organizational culture, such as alignment of values with their leaders.…”

Section: Methodsmentioning

confidence: 99%

A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study

et al. 2015

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BACKGROUND: Work conditions in primary care are associated with physician burnout and lower quality of care. OBJECTIVE: We aimed to assess if improvements in work conditions improve clinician stress and burnout. SUBJECTS: Primary care clinicians at 34 clinics in the upper Midwest and New York City participated in the study. STUDY DESIGN: This was a cluster randomized controlled trial. MEASURES: Work conditions, such as time pressure, workplace chaos, and work control, as well as clinician outcomes, were measured at baseline and at 12-18 months. A brief worklife and work conditions summary measure was provided to staff and clinicians at intervention sites. INTERVENTIONS: Diverse interventions were grouped into three categories: 1) improved communication; 2) changes in workflow, and 3) targeted quality improvement (QI) projects. ANALYSIS: Multilevel regressions assessed impact of worklife data and interventions on clinician outcomes. A multilevel analysis then looked at clinicians whose outcome scores improved and determined types of interventions associated with improvement. RESULTS: Of 166 clinicians, 135 (81.3 %) completed the study. While there was no group treatment effect of baseline data on clinician outcomes, more intervention clinicians showed improvements in burnout (21.8 % vs 7.1 % less burned out, p=0.01) and satisfaction (23.1 % vs 10.0 % more satisfied, p=0.04). Burnout was more likely to improve with workflow interventions [Odds Ratio (OR) of improvement in burnout 5.9, p=0.02], and with targeted QI projects than in controls (OR 4.8, p=0.02). Interventions in communication or workflow led to greater improvements in clinician satisfaction (OR 3.1, p=0.04), and showed a trend toward greater improvement in intention to leave (OR 4.2, p=0.06). LIMITATIONS:We used heterogeneous intervention types, and were uncertain how well interventions were instituted. CONCLUSIONS: Organizations may be able to improve burnout, dissatisfaction and retention by addressing communication and workflow, and initiating QI projects targeting clinician concerns.KEY WORDS: burnout; primary care; quality improvement; work conditions.

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“…Drawing from past studies of physician worklife and organizational research 13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] , items relevant to identified predictors and satisfaction domains were nonparsimoniously compiled into a single item bank. Psychometrically validated attitude questions and scales for established domains of satisfaction were modified to be applicable, meaningful, and appropriate to hospitalists.…”

Section: Survey Instrumentmentioning

confidence: 99%

Worklife and Satisfaction of Hospitalists: Toward Flourishing Careers

et al. 2011

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BACKGROUND:The number of hospitalists in the US is growing rapidly, yet little is known about their worklife to inform whether hospital medicine is a viable longterm career for physicians. OBJECTIVE: Determine current satisfaction levels among hospitalists. DESIGN: Survey study. METHODS: A national random stratified sample of 3,105 potential hospitalists plus 662 hospitalist employees of three multi-state hospitalist companies were administered the Hospital Medicine Physician Worklife Survey. Using 5-point Likert scales, the survey assessed demographic information, global job and specialty satisfaction, and 11 satisfaction domains: workload, compensation, care quality, organizational fairness, autonomy, personal time, organizational climate, and relationships with colleagues, staff, patients, and leader. Relationships between global satisfaction and satisfaction domains, and burnout symptoms and career longevity were explored. RESULTS: There were 816 hospitalist responses (adjusted response rate, 25.6%). Correcting for oversampling of pediatricians, 33.5% of respondents were women, and 7.4% were pediatricians. Overall, 62.6% of respondents reported high satisfaction (≥4 on a 5-point scale) with their job, and 69.0% with their specialty. Hospitalists were most satisfied with the quality of care they provided and relationships with staff and colleagues. They were least satisfied with organizational climate, autonomy, compensation, and availability of personal time. In adjusted analysis, satisfaction with organizational climate, quality of care provided, organizational fairness, personal time, relationship with leader, compensation, and relationship with patients predicted job satisfaction. Satisfaction with personal time, care quality, patient relationships, staff relationships, and compensation predicted specialty satisfaction. Job burnout symptoms were reported by 29.9% of respondents who were more likely to leave and reduce work effort. CONCLUSIONS:Hospitalists rate their job and specialty satisfaction highly, but burnout symptoms are common. Hospitalist programs should focus on organizational climate, organizational fairness, personal time, and compensation to improve satisfaction and minimize attrition.

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Validation of a single‐item measure of burnout against the Maslach Burnout Inventory among physicians

Cited by 399 publications

References 10 publications

Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey

Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey

A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study

Worklife and Satisfaction of Hospitalists: Toward Flourishing Careers

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