Ripp Jonathan A, Pietrzak Robert H, de Guillebon Eleonore, Peccoralo Lauren A
Office of Well-being and Resilience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, NY, NY 10029, USA; Department of Medical Education, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, NY, NY 10029, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, NY, NY 10029, USA.
U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT 06516, USA; Department of Psychiatry, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA.
Int J Med Inform. 2025 Mar;195:105740. doi: 10.1016/j.ijmedinf.2024.105740. Epub 2024 Dec 1.
To examine changes in clerical burden, including daily clerical time, daily after hours Electronic Health Record (EHR) time and EHR frustration between 2018 and 2022 among physician faculty, and identify sociodemographic and occupational correlates of clerical burden with burnout and intent to leave one's job (ILJ).
An institution-wide survey was sent to all physician faculty at an 8-Hospital Health System in New York City, between July and September 2022. Clerical time, after hours EHR time, practice unloading clerical burden and EHR frustration were assessed using ordinal-scale questions. Burnout was assessed using the Maslach Burnout Inventory-2. Demographic characteristics and ILJ were also assessed. Multivariable logistic regression analyses were conducted to determine associations between clerical burden and burnout and ILJ.
Daily clerical and after hours EHR time increased in 2022 compared with 2018-2019 data. Medicine- vs. hospital-based department and hours worked per week were associated with greater clerical and after hours EHR time, and female gender with greater after hours EHR time. After adjusting for demographic and occupational characteristics, greater clerical time and EHR frustration were associated with greater likelihood of burnout. Endorsement of practice efforts unloading burden was associated with lower odds of burnout. EHR frustration was associated with greater likelihood of ILJ. Junior faculty rank was linked to both burnout and ILJ.
Clerical burden may be increasing among physician faculty and may be linked to greater odds of burnout and intention to leave. Results underscore the importance of unloading this burden to maintain a healthy workforce and avoid strain on our healthcare system.
研究2018年至2022年间医师教员的文书工作负担变化，包括每日文书工作时间、每日非工作时间的电子健康记录（EHR）时间以及EHR使用挫败感，并确定文书工作负担与职业倦怠及离职意愿（ILJ）的社会人口统计学和职业相关性。
2022年7月至9月期间，向纽约市一个由8家医院组成的医疗系统中的所有医师教员发送了一份全机构范围的调查问卷。使用有序量表问题评估文书工作时间、非工作时间的EHR时间、减轻文书工作负担的措施以及EHR使用挫败感。使用马氏职业倦怠量表-2评估职业倦怠。还评估了人口统计学特征和离职意愿。进行多变量逻辑回归分析以确定文书工作负担与职业倦怠及离职意愿之间的关联。
与2018 - 2019年的数据相比，2022年的每日文书工作时间和非工作时间的EHR时间有所增加。医学科室与医院科室以及每周工作时长与更多的文书工作时间和非工作时间的EHR时间相关，女性与更多的非工作时间的EHR时间相关。在调整了人口统计学和职业特征后，更多的文书工作时间和EHR使用挫败感与更高的职业倦怠可能性相关。认可减轻负担的措施与较低的职业倦怠几率相关。EHR使用挫败感与更高的离职意愿可能性相关。初级教员职级与职业倦怠和离职意愿均相关。
医师教员的文书工作负担可能在增加，并且可能与更高的职业倦怠几率和离职意愿相关。结果强调了减轻这种负担对于维持健康劳动力以及避免给我们的医疗系统带来压力的重要性。
