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临床医生和工作人员的工作乐趣:从 Mini Z 调查中识别倦怠的补救预测指标。

Joy in Work for Clinicians and Staff: Identifying Remedial Predictors of Burnout from the Mini Z Survey.

机构信息

From the Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore (NK and EK); Discern Consulting, Baltimore, Maryland (RM).

出版信息

J Am Board Fam Med. 2020 May-Jun;33(3):357-367. doi: 10.3122/jabfm.2020.03.190458.

Abstract

PURPOSE

The CMS Transforming Clinical Practice Initiative (TCPI) provided during transition to new models of value-based care. Maryland ambulatory practices participated in the Garden Practice Transformation Network (GPTN) as a part of the TCPI. During practices assessment, we measured prevalence of burnout and identified its remediable predictors among GPTN-Maryland practices.

METHODS

A modified Mini Z tool survey was distributed among clinicians and staff in November 2018 - July 2019. Association between presence of burnout and burnout drivers was assessed using a Generalized Estimating Equation regression model for ordinal outcome.

RESULTS

Data from 166 responses were analyzed. Prevalence of burnout symptoms was 22%, with 35% enjoying their work. A 100-point Time Constraints/Teamwork (T/T) score was constructed using factors significantly associated with burnout symptoms. T/T score increase by 1 unit was associated with 10% increase in the odds of moving from the group experiencing burnout or stress to the group who found 'joy in work' (OR = 1.1, 95% CI 1.07, 1.13, p < 0.0001).

CONCLUSIONS

The Mini Z-derived T/T score could be useful for quick assessment of the degree of burnout and identifying burnout drivers related to effective organizational structure and supportive teamwork in .

摘要

目的

CMS 转化临床实践计划(TCPI)在向新的基于价值的护理模式过渡期间提供了支持。马里兰州的门诊实践作为 TCPI 的一部分参与了花园实践转型网络(GPTN)。在对实践进行评估时,我们测量了 GPTN-马里兰州实践中 burnout 的流行率,并确定了其可纠正的预测因素。

方法

在 2018 年 11 月至 2019 年 7 月期间,向临床医生和工作人员分发了经过修改的 Mini Z 工具调查。使用广义估计方程回归模型评估 burnout 及其驱动因素与存在之间的关联。

结果

对 166 份回复的数据进行了分析。出现 burnout 症状的比例为 22%,其中 35%的人喜欢自己的工作。使用与 burnout 症状显著相关的因素构建了 100 分的时间限制/团队合作(T/T)评分。T/T 评分增加 1 分,与从经历 burnout 或压力的组转移到发现“工作乐趣”的组的几率增加 10%相关(OR=1.1,95%CI 1.07,1.13,p<0.0001)。

结论

Mini Z 衍生的 T/T 评分可用于快速评估 burnout 的程度,并确定与有效的组织结构和支持性团队合作相关的 burnout 驱动因素。

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