Dunn Patrick M, Arnetz Bengt B, Christensen John F, Homer Louis
Department of Medicine, Legacy Health System, 1015 NW 22nd Avenue, Portland, OR, USA.
J Gen Intern Med. 2007 Nov;22(11):1544-52. doi: 10.1007/s11606-007-0363-5. Epub 2007 Sep 22.
Improving physician health and performance is critical to successfully meet the challenges facing health systems that increasingly emphasize productivity. Assessing long-term efficacy and sustainability of programs aimed at enhancing physician and organizational well-being is imperative.
To determine whether data-guided interventions and a systematic improvement process to enhance physician work-life balance and organizational efficacy can improve physician and organizational well-being.
From 2000 to 2005, 22-32 physicians regularly completed 3 questionnaires coded for privacy. Results were anonymously reported to physicians and the organization. Data-guided interventions to enhance physician and organizational well-being were built on physician control over the work environment, order in the clinical setting, and clinical meaning.
Questionnaires included an ACP/ASIM survey on physician satisfaction, the Maslach Burnout Inventory (MBI), and the Quality Work Competence (QWC) survey.
Emotional and work-related exhaustion decreased significantly over the study period (MBI, p = 0.002; QWC, p = 0.035). QWC measures of organizational health significantly improved initially and remained acceptable and stable during the rest of the study.
A data-guided program on physician well-being, using validated instruments and process improvement methods, enhanced physician and organizational well-being. Given the increases in physician burnout, organizations are encouraged to urgently create individual and systems approaches to lessen burnout risk.
改善医生的健康状况和工作表现对于成功应对卫生系统日益强调生产力所面临的挑战至关重要。评估旨在提高医生和组织福祉的项目的长期效果和可持续性势在必行。
确定以数据为导向的干预措施和旨在改善医生工作与生活平衡及组织效能的系统改进过程是否能提高医生和组织的福祉。
2000年至2005年期间,22至32名医生定期填写3份编码以保护隐私的问卷。结果以匿名方式报告给医生和组织。以数据为导向的旨在提高医生和组织福祉的干预措施基于医生对工作环境、临床环境秩序和临床意义的控制。
问卷包括一份关于医生满意度的美国内科医师学会/美国内科医学学会(ACP/ASIM)调查、马氏职业倦怠量表(MBI)和优质工作能力(QWC)调查。
在研究期间,情绪和工作相关的倦怠显著下降(MBI,p = 0.002;QWC,p = 0.035)。组织健康的QWC指标最初显著改善,并在研究的其余时间保持可接受且稳定。
一个以数据为导向的关于医生福祉的项目,使用经过验证的工具和过程改进方法,提高了医生和组织的福祉。鉴于医生职业倦怠的增加,鼓励各组织迫切制定个人和系统方法以降低倦怠风险。