Department of Health Administration and Policy, College of Public Health, George Mason University, 4400 University Drive MS IJ3, Fairfax, VA, 22030, USA.
Center for Evidence-Based Behavioral Health, George Mason University, Fairfax County, USA.
J Gen Intern Med. 2024 Jun;39(8):1317-1323. doi: 10.1007/s11606-023-08536-2. Epub 2023 Nov 27.
Clinician burnout has become a major issue in the USA, contributing to increased mental health challenges and problems with quality of care, productivity, and retention.
The objective of this study was to understand primary care clinicians' perspectives on burnout during the COVID-19 pandemic as well as their perspectives on the causes of burnout and strategies to improve clinician well-being.
This qualitative research involved in-depth interviews with 27 primary care clinicians practicing in a range of settings across the USA. Semi-structured interviews lasted between 60 and 90 min and were conducted using Zoom video conferencing software between July 2021 and February 2023. Transcripts were analyzed in NVivo software using multiple cycles of coding.
Clinicians shared their experiences with burnout and mental health challenges during the COVID-19 pandemic. Contributors to burnout included high levels of documentation, inefficiencies of electronic health record (EHR) systems, high patient volume, staffing shortages, and expectations for responding to patient emails and telephone calls. The majority of participants described the need to work after clinic hours to complete documentation. Many clinicians also discussed the need for health system leaders to make sincere efforts to enhance work-life balance and create a culture of health and well-being for health professionals. Suggested strategies to address these issues included supportive leadership, accessible mental health services, and additional administrative time to complete documentation.
The results of this study provide an in-depth view of participating primary care clinicians' experiences and perceptions of burnout and other mental health challenges. These viewpoints can improve awareness of the issues and strategies to improve the health and well-being of our clinician workforce. Strategies include aligning payment models with the best approaches for delivering quality patient care, reducing administrative burden related to documentation, and redesigning EHR systems with a human factors approach.
在美国，临床医生倦怠已成为一个主要问题，导致心理健康挑战加剧，并出现医疗质量下降、生产力下降和人员保留等问题。
本研究旨在了解 COVID-19 大流行期间初级保健临床医生对倦怠的看法，以及他们对倦怠原因和改善临床医生健康策略的看法。
这项定性研究采用深入访谈的方式，对美国各地不同环境下工作的 27 名初级保健临床医生进行了访谈。半结构式访谈持续 60 至 90 分钟，于 2021 年 7 月至 2023 年 2 月期间使用 Zoom 视频会议软件进行。使用 NVivo 软件对转录本进行多次编码分析。
临床医生分享了他们在 COVID-19 大流行期间经历的倦怠和心理健康挑战。导致倦怠的因素包括大量的文件记录、电子病历（EHR）系统效率低下、患者数量多、人员短缺，以及对回复患者电子邮件和电话的期望。大多数参与者表示需要在诊所工作时间之外完成文件记录。许多临床医生还讨论了卫生系统领导者真诚努力改善工作与生活平衡并为卫生专业人员创造健康和幸福文化的必要性。建议采取的策略包括提供支持性领导、提供便捷的心理健康服务以及增加完成文件记录的管理时间。
本研究结果深入了解了参与的初级保健临床医生对倦怠和其他心理健康挑战的经历和看法。这些观点可以提高对这些问题的认识，并为改善我们的临床医生队伍的健康和福祉制定策略。这些策略包括使支付模式与提供优质患者护理的最佳方法保持一致，减少与文件记录相关的行政负担，以及采用以人为中心的方法重新设计 EHR 系统。
