Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, 585 University Avenue LPMB 119 K, M5G 2N2, Toronto, ON, Canada.
Goldfarb Intelligence Marketing, Toronto, Canada.
BMC Health Serv Res. 2024 Feb 26;24(1):246. doi: 10.1186/s12913-024-10669-x.
Clinician distress is a multidimensional condition that includes burnout, decreased meaning in work, severe fatigue, poor work-life integration, reduced quality of life, and suicidal ideation. It has negative impacts on patients, providers, and healthcare systems. In this three-phase qualitative investigation, we identified workplace-related factors that drive clinician distress and co-designed actionable interventions with inter-professional cardiovascular clinicians to decrease their distress and improve well-being within a Canadian quaternary hospital network.
Between October 2021 and May 2022, we invited nurses, allied health professionals, and physicians to participate in a three-phase qualitative investigation. Phases 1 and 2 included individual interviews and focus groups to identify workplace-related factors contributing to distress. Phase 3 involved co-design workshops that engaged inter-professional clinicians to develop interventions addressing drivers of distress identified. Qualitative information was analyzed using descriptive thematic analysis.
Fifty-one clinicians (24 nurses, 10 allied health professionals, and 17 physicians) participated. Insights from Phases 1 and 2 identified five key thematic drivers of distress: inadequate support within inter-professional teams, decreased joy in work, unsustainable workloads, limited opportunities for learning and professional growth, and a lack of transparent leadership communication. Phase 3 co-design workshops yielded four actionable interventions to mitigate clinician distress in the workplace: re-designing daily safety huddles, formalizing a nursing coaching and mentorship program, creating a value-added program e-newsletter, and implementing an employee experience platform.
This study increases our understanding on workplace-related factors that contribute to clinician distress, as shared by inter-professional clinicians specializing in cardiovascular care. Healthcare organizations can develop effective interventions to mitigate clinician distress by actively engaging healthcare workers in identifying workplace drivers of distress and collaboratively designing tailored, practical interventions that directly address these challenges.
临床医生的痛苦是一种多维状态，包括倦怠、工作意义降低、严重疲劳、工作与生活融合不良、生活质量下降和自杀意念。它对患者、医护人员和医疗保健系统都有负面影响。在这项三阶段定性研究中，我们确定了导致临床医生痛苦的工作场所相关因素，并与跨专业心血管临床医生共同设计了可操作的干预措施，以减少他们在加拿大四级医院网络中的痛苦并提高幸福感。
在 2021 年 10 月至 2022 年 5 月期间，我们邀请护士、辅助医疗专业人员和医生参加三阶段定性研究。第 1 阶段和第 2 阶段包括个人访谈和焦点小组，以确定导致痛苦的工作场所相关因素。第 3 阶段涉及共同设计工作坊，让跨专业临床医生参与制定针对确定的痛苦驱动因素的干预措施。使用描述性主题分析对定性信息进行分析。
共有 51 名临床医生（24 名护士、10 名辅助医疗专业人员和 17 名医生）参与。第 1 阶段和第 2 阶段的见解确定了痛苦的五个关键主题驱动因素：跨专业团队内部支持不足、工作乐趣降低、工作量不可持续、学习和职业发展机会有限以及缺乏透明的领导沟通。第 3 阶段的共同设计工作坊产生了四项减轻工作场所临床医生痛苦的可操作干预措施：重新设计日常安全讨论、正式实施护理辅导和指导计划、创建增值计划电子通讯、以及实施员工体验平台。
这项研究增加了我们对导致跨专业心血管护理临床医生痛苦的工作场所相关因素的理解。医疗保健组织可以通过积极让医护人员参与确定工作场所痛苦的驱动因素，并共同设计直接解决这些挑战的量身定制的实用干预措施，来开发有效的干预措施来减轻临床医生的痛苦。
