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Abstract
Background Physician burnout has a negative effect on the quality of care; however, effective interventions are lacking.
Objectives To identify and impact key drivers of physician workplace satisfaction in an academic pediatric department.
Methods A quality improvement approach was used to impact key drivers of faculty workplace satisfaction. In 2017, 2018, and 2019 faculty completed anonymous surveys that combined the Maslach Burnout Inventory(MBI) and Areas of Worklife Survey(AWS). Interventions included changes to compensation plan, clinical practice, departmental communication, workplace community, individual wellness, and culture. Descriptive statistics and data visualization were performed. Two-sided t-tests and ANOVA regression analysis were used to compare responses.
Results Survey completion rates were: 160/195 (82%) in 2019; 139/180 (77%) in 2018; and 155/171 (91%) in 2017; 101 physicians completed all three surveys. Statistically significant improvements were observed in reward (3.4 vs 3.3; p<0.05) and values (3.6 vs 3.5; p<0.05) domains of the AWS in 2019 and 2018 versus 2017. MBI average scores were similar in all three years, and remained significantly better than the general population in depersonalization (1.0 vs. 1.7; p<0.0001) and personal accomplishment domains (5.0 vs. 4.3; p<0.0001). There was no difference in the emotional exhaustion domain. Worse emotional exhaustion scores were reported in women (2.8 vs 2.1; p<0.05) and those working >75% clinical effort (2.8 vs 2.1; p<0.05).
Key driver diagram
Association between emotional exhaustion score and gender, adjustiong for workload for 101 participants responding in 2017, 2018 and 2019 using ANOVA regression analysis. A lower mean score in emotional exhaustion domain is better
Association between emotional exhaustion score and percent of tme providing clinical care, adjustiong for workload for 101 participants responding in 2017, 2018 and 2019 using ANOVA regression analysis. A lower mean score in emotional exhaustion domain is better
Average ratings of the Maslach Burnout Inventory (MBI) and Areas of Worklife Survey (AWS) compared to norms of participants (N=101) responding to the survey all three years. The ‘general population’ for AWS survey includes people across a diversity of organizations whereas it includes health care workers for the MBI. Participant scores for depersonalization, personal accomplishment, reward, community, fairness, and values are better than the general population. The response for reward and fairness became significantly better in 2018 and 2019 compared to 2017. The average participant score for workload is worse than the general population
Average ratings of the Areas of Worklife Survey (AWS) compared to norms in 2017, 2018, and 2019. The ‘general population’ for AWS survey includes people across a diversity of organizations. Participant scores for depersonalization, personal accomplishment, reward, community, fairness, and values are better than the general population. The response for reward and fairness became significantly better in 2018 and 2019 compared to 2017. The average participant score for workload is worse than the general population
Conclusions Interventions targeting the workplace improved physicians’ experience of reward and values. Risk factors associated with a high emotional exhaustion score included female gender or individuals working >75% clinical effort.