Centre for Addiction and Mental Health, Toronto, Ontario, Canada
University of Toronto, Toronto, Ontario, Canada.
BMJ Lead. 2023 Sep;7(3):182-188. doi: 10.1136/leader-2022-000595. Epub 2022 Nov 25.
This study aims to evaluate the impact of several organisational initiatives implemented as part of a physician engagement, wellness and excellence strategy at a large mental health hospital. Interventions that were examined include: communities of practice, peer support programme, mentorship programme and leadership and management programme for physicians.
A cross-sectional study, guided by the Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance evaluation framework, was conducted with physicians at a large academic mental health hospital in Toronto, Canada. Physicians were invited to complete an online survey in April 2021, which composed of questions on the awareness, use and perceived impact of the organisational wellness initiatives and the two-item Maslach Burnout Inventory tool. The survey was analysed using descriptive statistics and a thematic analysis.
103 survey responses (40.9% response rate) were gathered from physicians, with 39.8% of respondents reporting experiences of burn-out. Overall, there was variable reach and suboptimal use of the organisational interventions reported by physicians. Themes emerging from open-ended questions included the importance of addressing: workload and resource related factors; leadership and culture related factors; and factors related to the electronic medical record and virtual care.
Organisational strategies to address physician burn-out and support physician wellness require repeated evaluation of the impact and relevance of initiatives with physicians, taking into account organisational culture, external variables, emerging barriers to access and participation, and physician needs and interest over time. These findings will be embedded as part of ongoing review of our organisational framework to guide changes to our physician engagement, wellness and excellence strategy.
本研究旨在评估作为大型精神卫生医院医生参与、健康和卓越战略的一部分实施的几项组织举措的影响。所检查的干预措施包括:实践社区、同行支持计划、指导计划和医生领导力和管理计划。
一项基于 Reach、Effectiveness/Efficacy、Adoption、Implementation 和 Maintenance 评估框架的横断面研究在加拿大多伦多的一家大型学术精神卫生医院的医生中进行。医生被邀请在 2021 年 4 月完成在线调查,该调查由关于组织健康倡议的意识、使用和感知影响以及 Maslach 倦怠量表的两个项目的问题组成。使用描述性统计和主题分析对调查进行了分析。
从医生那里收集了 103 份调查回复(40.9%的回复率),其中 39.8%的受访者报告经历了倦怠。总体而言,医生报告的组织干预措施的可及性和使用情况各不相同。开放式问题中出现的主题包括解决以下因素的重要性:工作量和资源相关因素;领导力和文化相关因素;以及与电子病历和虚拟护理相关的因素。
解决医生倦怠和支持医生健康的组织策略需要反复评估与医生一起实施的举措的影响和相关性,同时考虑组织文化、外部变量、获取和参与的新障碍以及医生随时间推移的需求和兴趣。这些发现将作为我们组织框架持续审查的一部分,以指导我们的医生参与、健康和卓越战略的变革。