Leyenaar JoAnna K, Capra Lisa A, O'Brien Emily R, Leslie Laurel K, Mackie Thomas I
Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass.
Floating Hospital for Children at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass.
Acad Pediatr. 2014 Jul-Aug;14(4):361-8. doi: 10.1016/j.acap.2014.03.015.
To characterize determinants of career satisfaction among pediatric hospitalists working in diverse practice settings; to develop a framework to conceptualize factors influencing career satisfaction.
Semistructured interviews were conducted with community and tertiary care hospitalists, using purposeful sampling to attain maximum response diversity. We used closed- and open-ended questions to assess levels of career satisfaction and its determinants. Interviews were conducted by telephone, recorded, and transcribed verbatim. Emergent themes were identified and analyzed using an inductive approach to qualitative analysis.
A total of 30 interviews were conducted with community and tertiary care hospitalists, representing 20 hospital medicine programs and 7 Northeastern states. Qualitative analysis yielded 657 excerpts, which were coded and categorized into 4 domains and associated determinants of career satisfaction: 1) professional responsibilities; 2) hospital medicine program administration; 3) hospital and health care systems; and 4) career development. Although community and tertiary care hospitalists reported similar levels of career satisfaction, they expressed variation in perspectives across these 4 domains. Although the role of hospital medicine program administration was consistently emphasized by all hospitalists, community hospitalists prioritized resource availability, work schedule, and clinical responsibilities, while tertiary care hospitalists prioritized diversity in nonclinical responsibilities and career development.
We illustrate how hospitalists in different organizational settings prioritize both consistent and unique determinants of career satisfaction. Given associations between physician satisfaction and health care quality, efforts to optimize modifiable factors within this framework, at both community and tertiary care hospitals, may have broad impacts.
描述在不同执业环境中工作的儿科住院医师职业满意度的决定因素；建立一个框架来概念化影响职业满意度的因素。
对社区和三级医疗住院医师进行半结构化访谈，采用目的抽样以获得最大的回答多样性。我们使用封闭式和开放式问题来评估职业满意度水平及其决定因素。通过电话进行访谈，录音并逐字转录。使用归纳法进行定性分析来识别和分析新出现的主题。
共对社区和三级医疗住院医师进行了30次访谈，代表20个医院医学项目和美国东北部7个州。定性分析产生了657条摘录，编码并归类为职业满意度的4个领域及相关决定因素：1）专业职责；2）医院医学项目管理；3）医院和医疗保健系统；4）职业发展。尽管社区和三级医疗住院医师报告的职业满意度水平相似，但他们在这4个领域的观点存在差异。虽然所有住院医师都一直强调医院医学项目管理的作用，但社区住院医师将资源可用性、工作时间表和临床职责列为优先事项，而三级医疗住院医师则将非临床职责的多样性和职业发展列为优先事项。
我们说明了不同组织环境中的住院医师如何对职业满意度的一致和独特决定因素进行优先排序。鉴于医生满意度与医疗质量之间的关联，在社区和三级医疗医院努力优化该框架内的可改变因素可能会产生广泛影响。
