National Clinician Scholars Program, University of California at Los Angeles (Drs Martinez-Hollingsworth and Choi); Cedars Sinai, Los Angeles, California (Dr Kim); Graduate School of Education and Psychology, Howard Hughes Center, Pepperdine University, Los Angeles, California (Ms Richardson); Medical Education Department, AltaMed Institute for Health Equity, Los Angeles, California (Drs Angulo and Liu); Department of Internal Medicine and Division of Endocrinology, Metabolism and Molecular Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, California (Dr Friedman); and Department of Research & Evaluation, Kaiser Permanente Southern California Pasadena, California, and School of Nursing, University of California at Los Angeles (Dr Choi).
J Ambul Care Manage. 2021;44(3):172-183. doi: 10.1097/JAC.0000000000000383.
Organizational factors impacting burnout have been underexplored among providers in low-income, minority-serving, safety-net settings. Our team interviewed 14 health care administrators, serving as key decision makers in Federally Qualified Health Center primary care clinics. Using a semistructured interview guide, we explored burnout mitigation strategies and elements of organizational culture and practice. Transcribed interviews were coded and analyzed using the Braun and Clark (2006) Thematic Analysis method. Mission-Driven Ethos to Mitigate Provider Burnout emerged as the primary theme with 2 categories: (1) Promoting the Mission: "Bleeders" and (2) Competing Priorities: "Billers." These categories represent various properties and reflect administrators' use of organizational mission statement as a driver of staff recruitment, training, retention, and stratification. Data collection occurred before and during the COVID-19 global pandemic, as such additional themes associated with administrative behaviors during a prolonged, clinical crisis provide insight into possible strategies that may mitigate burnout in this setting.
在服务低收入人群和少数族裔的医疗保障网络机构中，组织因素对医生职业倦怠的影响尚未得到充分研究。我们的团队采访了 14 名医疗保健管理人员，他们是联邦合格医疗中心初级保健诊所的主要决策者。使用半结构化访谈指南，我们探讨了减轻倦怠的策略以及组织文化和实践的要素。使用 Braun 和 Clark（2006）的主题分析方法对转录的访谈进行了编码和分析。以使命为导向的精神来减轻提供者的倦怠是主要主题，有两个类别：（1）推动使命：“出血者”和（2）竞争优先事项：“开票人”。这些类别代表了各种特性，并反映了管理人员将组织使命陈述用作员工招聘、培训、保留和分层的驱动因素。数据收集发生在 COVID-19 全球大流行之前和期间，因此与临床危机期间行政行为相关的其他主题为了解可能减轻这种环境中倦怠的策略提供了一些思路。
