Marshburn Alexander W, Riazi Gabrielle, Menezes Sabrina, Ramirez Stephanie, Guldner Gregory, Wells Jessica C, Siegel Jason T
Claremont Graduate University, Claremont, CA.
CA Healthcare Graduate Medical Education, Brentwood, TN.
HCA Healthc J Med. 2024 Jun 1;5(3):251-263. doi: 10.36518/2689-0216.1808. eCollection 2024.
This study evaluated wellness programs in a large hospital network to determine residency program directors' (PDs) perspectives on their wellness programs' state, including wellness prioritization, frequency of wellness activities, and wellness' influence on decision-making across organizational levels.
In 2021, 211 PDs were sent surveys on program policies, program implementation frequency, perceptions of the administration's ability to prioritize wellness, funding sources, and perceptions of resident wellness' impact on decision-making.
Among 211 contacted programs, 148 surveys were completed (70.1%). The majority reported having wellness programs, committees, and funding. Fewer than 25% reported having a chief wellness officer. PDs perceived that fellow colleagues in their institution linked wellness to markers of institutional success to a greater extent than other available options (ie, Accreditation Council for Graduate Medical Education [ACGME] requirements, budgetary concerns, resident input, core faculty priorities, and education quality). Financial well-being was perceived as least connected to wellness. Perceptions of wellness were rated across 3 organizational levels: program, institution, and organization. Across all levels, ACGME requirements (31.0%-32.8%) and budgetary/financial concerns (21.9%-37.0%) were perceived as having the most significant influence on overall decision-making, whereas resident wellness was rated lower in influence (8.0%-12.2%). Most programs allowed residents to attend mental health appointments without using paid time off (87.9%) and while on duty (83.1%).
The frequency of wellness activities varied greatly across programs. PDs reported challenges making resident self-care and personal development a priority and perceived resident wellness as having limited importance to decision-making at higher levels.
本研究评估了一个大型医院网络中的健康计划,以确定住院医师培训项目主任(PDs)对其健康计划状况的看法,包括健康优先级、健康活动频率以及健康对各级组织决策的影响。
2021年,向211名PDs发送了关于项目政策、项目实施频率、对管理层优先考虑健康能力的看法、资金来源以及对住院医师健康对决策影响的看法的调查问卷。
在211个联系的项目中,完成了148份调查问卷(70.1%)。大多数项目报告有健康计划、委员会和资金。报告设有首席健康官的项目不到25%。PDs认为,与其他可用选项(即研究生医学教育认证委员会[ACGME]要求、预算问题、住院医师意见、核心教员优先事项和教育质量)相比,他们所在机构的同事在更大程度上将健康与机构成功的标志联系起来。财务健康被认为与健康的联系最少。对健康的看法在项目、机构和组织三个组织层面进行评分。在所有层面上,ACGME要求(31.0%-32.8%)和预算/财务问题(21.9%-37.0%)被认为对总体决策影响最大,而住院医师健康的影响被评为较低(8.0%-12.2%)。大多数项目允许住院医师在不使用带薪休假(87.9%)和值班期间(83.1%)参加心理健康预约。
各项目的健康活动频率差异很大。PDs报告称,将住院医师的自我护理和个人发展作为优先事项存在挑战,并认为住院医师健康对高层决策的重要性有限。