Pian Julia, Cannon Brittnie, Schnipper Jeffrey L, Levine David M
Harvard Medical School; Boston, MA, USA.
Harvard Catalyst Summer Clinical and Translational Research Program; Boston, MA, USA.
J Clin Med Res. 2019 Jul;11(7):484-488. doi: 10.14740/jocmr3842. Epub 2019 Jun 11.
Burnout affects large portions of the healthcare workforce and is associated with increased medical errors, decreased patient experience and adherence, loss of professionalism, and decreased productivity. Little data exists on how novel clinical care settings might impact burnout. We studied the experience and burnout of staff involved in a home hospital pilot, where acutely ill patients were cared for at home as a substitute for traditional hospitalization.
We analyzed evaluations completed by home hospital staff (physicians, registered nurses, and research assistants) at the conclusion of a 2-month pilot program. Our primary outcome was burnout evaluated by the Mini Z Burnout Survey. Secondary outcomes included overall job satisfaction, work environment, workload, and team evaluation measured on a 5-point Likert scale.
Eight of nine (89%) staff completed evaluations. Seven of eight (88%) staff had no symptoms of burnout; one (13%) was under stress but did not feel burned out. Median overall satisfaction with home hospital was 4.5/5.0 (interquartile range (IQR), 1.0). Most staff (6/8; 75%) "strongly agreed" that their professional values were well-aligned with the program. Three of six (50%) "entirely" or "very much" preferred home hospital to their standard clinical setting. Six of eight (75%) staff felt that their opinions were "entirely" heard; four of eight (50%) felt the team "entirely" valued each of its participants.
Novel clinical care settings like home hospital may lead to low staff burnout, high job satisfaction, and a healthy work environment. Further study is warranted.
职业倦怠影响着很大一部分医疗工作者，且与医疗差错增加、患者体验和依从性下降、职业素养丧失以及工作效率降低有关。关于新型临床护理模式如何影响职业倦怠的数据很少。我们研究了参与家庭医院试点项目的工作人员的体验和职业倦怠情况，在该项目中，急症患者在家中接受护理以替代传统住院治疗。
我们分析了家庭医院工作人员（医生、注册护士和研究助理）在为期2个月的试点项目结束时完成的评估。我们的主要结局是通过Mini Z职业倦怠调查评估的职业倦怠。次要结局包括总体工作满意度、工作环境、工作量以及用5分李克特量表衡量的团队评估。
9名工作人员中有8名（89%）完成了评估。8名工作人员中有7名（88%）没有职业倦怠症状；1名（13%）处于压力之下，但未感到倦怠。对家庭医院的总体满意度中位数为4.5/5.0（四分位间距（IQR），1.0）。大多数工作人员（6/8；75%）“强烈同意”他们的职业价值观与该项目高度一致。6名工作人员中有3名（50%）“完全”或“非常”更喜欢家庭医院而非他们的标准临床环境。8名工作人员中有6名（75%）觉得他们的意见“完全”被听取；8名工作人员中有4名（50%）觉得团队“完全”重视每一位参与者。
像家庭医院这样的新型临床护理模式可能导致工作人员职业倦怠率低、工作满意度高以及拥有健康的工作环境。有必要进行进一步研究。
