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多学科方法在美国大都市医疗集团中提高医护人员幸福感。

Multidisciplinary approach to enhancing provider well-being in a metropolitan medical group in the United States.

机构信息

Norton Neuroscience Institute, Norton Healthcare, 210 East Gray Street, Suite 1102, Louisville, KY, 40202, USA.

Norton Medical Group, Norton Healthcare, Louisville, KY, USA.

出版信息

BMC Fam Pract. 2020 Dec 6;21(1):262. doi: 10.1186/s12875-020-01323-6.

Abstract

BACKGROUND

Physician burnout refers to depersonalization, emotional exhaustion, and a sense of lower personal accomplishment. Affecting approximately 50% of physicians in the United States, physician burnout negatively impacts both the physician and patient. Over a 3-year-period, this prospective study evaluated the multidisciplinary approach to decreasing provider burnout and improving provider well-being in our metropolitan community.

METHODS

A multidisciplinary Well-Being Task Force was established at our Institution in 2017 to assess the myriad factors that may play a role in provider burnout and offer solutions to mitigate the stressors that may lead to decreased provider well-being. Four multifaceted strategies were implemented: (1) provider engagement & growth; (2) workflow/office efficiencies; (3) relationship building; and (4) communication. Providers at our Institution took the Mayo Clinic's well-being index survey on 3 occasions over 3 years. Their scores were compared to those of providers nationally at baseline and at 1 and 2 years after implementing organizational and individualized techniques to enhance provider well-being. Lower well-being index scores reflected better well-being.

RESULTS

The average overall well-being index scores of our Institution's providers decreased from 1.76 at baseline to 1.32 2 years later compared to an increase in well-being index scores of physicians nationally (1.73 to 1.85). Both male and female providers' average well-being index scores at our Institution decreased over the 3 years of this study, from 1.72 to 1.58 for males and 1.78 to 1.21 for females, while physicians' scores nationally increased for both genders. The average well-being index scores were highest for providers at our Institution who graduated from medical school less than 5 years earlier (2.0) and who graduated 15-24 years earlier (2.3), whereas the average lowest scores were observed in providers who graduated ≥25 years earlier (1.37). Obstetricians/gynecologists and internal medicine physicians had the highest average well-being index scores (2.48 and 2.4, respectively) compared to other medical specialties. The turnover rate of our Institution's providers was 5.6% in 2017 and 3.9% in 2019, reflecting a 30% decrease.

CONCLUSION

This study serves as a model to reduce provider burnout and enhance well-being through both organizational and individual interventions.

摘要

背景

医生职业倦怠是指去人性化、情绪耗竭和成就感降低。在美国,大约有 50%的医生受到职业倦怠的影响,这对医生和患者都有负面影响。在三年的时间里,这项前瞻性研究评估了减少医疗服务提供者倦怠和改善大都市社区医疗服务提供者幸福感的多学科方法。

方法

2017 年,我们的机构成立了一个多学科的幸福感工作组,以评估可能导致提供者倦怠的众多因素,并提供减轻可能导致提供者幸福感降低的压力源的解决方案。实施了四项多方面的策略:(1)提供者参与和成长;(2)工作流程/办公室效率;(3)建立关系;和(4)沟通。我们机构的提供者在三年内三次接受了梅奥诊所的幸福感指数调查。他们的分数与基线时以及实施组织和个性化技术以提高提供者幸福感后的 1 年和 2 年的全国提供者的分数进行了比较。较低的幸福感指数反映了更好的幸福感。

结果

与全国医生的幸福感指数得分从 1.73 增加到 1.85 相比,我们机构的提供者的整体幸福感指数平均值从基线时的 1.76 下降到 2 年后的 1.32。在这项研究的三年中,我们机构的男性和女性提供者的平均幸福感指数都有所下降,男性从 1.72 下降到 1.58,女性从 1.78 下降到 1.21,而全国医生的分数则在两性中都有所增加。幸福感指数得分最高的是我们机构的那些毕业不到 5 年的医生(2.0)和毕业 15-24 年的医生(2.3),而得分最低的是毕业≥25 年的医生(1.37)。妇产科医生和内科医生的平均幸福感指数得分最高(分别为 2.48 和 2.4),与其他医学专业相比。我们机构的提供者的离职率在 2017 年为 5.6%,在 2019 年为 3.9%,下降了 30%。

结论

这项研究通过组织和个人干预措施为减少医疗服务提供者的倦怠和提高幸福感提供了一个模式。

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