From Army Public Health Center, Health Promotion and Wellness Directorate, Public Health Assessment Division, Aberdeen Proving Ground, MD (AMC, JAB); General Dynamics Information Technology, Reston, VA (AMC); Former Oak Ridge Institute for Science and Education participant in support of Army Public Health Center, Health Promotion and Wellness Directorate, Public Health Assessment Division, Belcamp, MD (MMH); Wozniak University, Box Elder, South Dakota (MMH); Madigan Army Medical Center, Joint Base Lewis-McChord, WA (RCO); United States Central Command, Tampa, FL (TSF); Former General Dynamics Information Technology contractor in support of Army Public Health Center, Health Promotion and Wellness Directorate, Public Health Assessment Division (LOR).
J Am Board Fam Med. 2020 May-Jun;33(3):440-445. doi: 10.3122/jabfm.2020.03.190350.
In 2015, the Army Office of the Surgeon General adapted a Veterans Health Administration course for health care teams to implement holistic health practices to improve the resiliency of health care teams and patient care. The Army course Move to Health was piloted in health care teams at 8 military clinics. During the 20-hour course, health care teams learned techniques to improve their resiliency and created action plans to incorporate holistic health into the workplace, a known factor in decreasing burnout.
A process and outcome evaluation of this course was conducted using a within-group design. Surveys were administered to health care teams at precourse and 2-month follow-up, and 186 participants completed both surveys.
Burnout among team members did not significantly change from precourse (52%, n = 96) to follow-up (48%, n = 90). At follow-up, team members described using resiliency building strategies for self-care, significantly improved their self-efficacy to treat patients holistically in the patient-centered care home model, and reported increased satisfaction with patient centered care home (all are < 0.01). However, 70% (n = 131) of team members reported that they had not completed action plan implementation and did not report improved job satisfaction.
Informed by the literature, Move to Health combines an individual resiliency intervention with organizational change, facilitating action plans to mitigate burnout. This manuscript explores potential reasons for why burnout did not significantly change within the 2-month period following the intervention. Reducing burnout among health care teams is vital to ensure that optimal health care is provided to the military and its beneficiaries.
2015 年，陆军军医处处长为医疗团队改编了退伍军人健康管理局的课程，以实施整体健康实践，提高医疗团队和患者护理的恢复力。陆军课程“迈向健康”在 8 个军事诊所的医疗团队中进行了试点。在 20 小时的课程中，医疗团队学习了提高适应力的技巧，并制定了将整体健康纳入工作场所的行动计划，这是减少倦怠的已知因素。
采用组内设计对该课程进行了过程和结果评估。在课前和 2 个月的随访中向医疗团队发放了调查问卷，共有 186 名参与者完成了两次调查。
与课前（52%，n=96）相比，团队成员的倦怠感在随访中没有显著变化（48%，n=90）。在随访时，团队成员描述了使用恢复力建设策略进行自我保健，在以患者为中心的家庭医疗模式下，整体治疗患者的自我效能显著提高，并报告对以患者为中心的家庭医疗满意度提高（均<0.01）。然而，70%（n=131）的团队成员报告说他们没有完成行动计划的实施，并且没有报告工作满意度的提高。
受文献启发，“迈向健康”将个体适应力干预与组织变革相结合，促进实施行动计划以减轻倦怠。本文探讨了为什么在干预后 2 个月内倦怠感没有显著变化的潜在原因。减少医疗团队的倦怠感对于确保为军队及其受益人提供最佳医疗保健至关重要。
