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运用医疗保健改进研究所工作幸福感框架提高澳大利亚维多利亚州医护人员的工作幸福感并减少职业倦怠:一项混合方法研究

Improving joy at work and reducing burnout in health care workers in Victoria, Australia using the Institute for Healthcare Improvement joy in work framework: A mixed-methods study.

作者信息

Jordan Joanne E, Garner Kerryn, Bones Kate, McKenzie Lisa, Linzer Mark, Rathert Cheryl, Goelz Elizabeth, McCall Jesse, Sawyer Eleanor, Baass Briana, Herco Fiona

出版信息

Health Care Manage Rev. 2025;50(1):3-12. doi: 10.1097/HMR.0000000000000420. Epub 2024 Oct 28.

Abstract

BACKGROUND

Burnout in health care workers (HCWs) has serious ramifications for individual well-being, patients, organizations, and health systems. Global evidence demonstrates the COVID-19 pandemic has amplified the risk of burnout. Scalable interventions to address burnout are critical to protect HCW well-being.

PURPOSE

Underpinned by the Conservation of Resources theory, this study examines the impacts of a statewide improvement initiative (the Initiative), using the Institute for Healthcare Improvement Joy in Work (JiW) Framework, to reduce burnout and increase joy at work across participating health care organizations in Victoria, Australia.

METHODOLOGY/APPROACH: An impact evaluation was undertaken utilizing a mixed-methods design. Quantitative outcomes included burnout and joy at work measured using an adapted Mini Z tool. In-depth interviews with implementation teams sought insights into the effectiveness of interventions.

RESULTS

Overall, 20 teams from 17 organizations across diverse health care settings and geographical locations participated. At a statewide level, outcomes in burnout and joy at work were inconclusive due to limited data. However, five out of eight teams reporting sufficient data achieved measurable improvements in one or more outcomes. Qualitative data revealed the Initiative increased workplace resources and supports such as providing "permission" for HCWs to prioritize well-being at work, improved communications between management and HCWs, and increased HCWs' teamwork and camaraderie, resulting in safer and more positive workplaces.

CONCLUSION AND PRACTICE IMPLICATIONS

The JiW Framework, implemented across diverse settings, provided organizations with a structured process to develop multifaceted improvements that resulted in enhanced resources that appeared to improve HCW well-being. Compared to individual well-being support, this approach offers organization-level change and scalability potential.

摘要

背景

医护人员的职业倦怠对个人幸福、患者、组织和卫生系统都有严重影响。全球证据表明,新冠疫情加剧了职业倦怠的风险。采取可扩展的干预措施来解决职业倦怠问题对于保护医护人员的幸福至关重要。

目的

本研究以资源守恒理论为基础,运用医疗改进研究所的工作乐趣(JiW)框架,考察一项全州范围的改进计划(该计划)对澳大利亚维多利亚州参与的医疗保健机构减少职业倦怠和增加工作乐趣的影响。

方法/途径:采用混合方法设计进行影响评估。定量结果包括使用改编后的Mini Z工具测量的职业倦怠和工作乐趣。对实施团队进行深入访谈,以深入了解干预措施的有效性。

结果

总体而言,来自不同医疗保健环境和地理位置的17个组织的20个团队参与了研究。在全州范围内,由于数据有限,职业倦怠和工作乐趣的结果尚无定论。然而,在报告有足够数据的八个团队中,有五个团队在一个或多个结果上取得了可衡量的改善。定性数据显示,该计划增加了工作场所的资源和支持,例如允许医护人员在工作中优先考虑自身幸福,改善了管理层与医护人员之间的沟通,并增强了医护人员的团队合作和情谊,从而营造了更安全、更积极的工作场所。

结论及实践意义

在不同环境中实施的JiW框架为组织提供了一个结构化的过程,以开展多方面的改进,从而增加资源,似乎改善了医护人员的幸福。与个人幸福支持相比,这种方法具有组织层面变革和可扩展性的潜力。

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