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通过工作流程重新设计减少医生职业倦怠:一项质量改进计划。

Reducing Physician Burnout Through Workflow Redesign: A Quality-Improvement Initiative.

作者信息

Goebel Jennifer, Sidle Jessica, Aspiras Alma, Fow Leah, McCann-Pineo Molly, Li Timmy

机构信息

Emergency Department, Northwell Health, New Hyde Park, USA.

Case Management, Northwell Health, New Hyde Park, USA.

出版信息

Cureus. 2025 Jun 11;17(6):e85799. doi: 10.7759/cureus.85799. eCollection 2025 Jun.

Abstract

Introduction Staff well-being is a critical element in any healthcare organization's framework. Improving provider and staff well-being is increasingly recognized as essential to high-quality care. Burnout among healthcare workers is often driven by excessive administrative demands, inefficient workflows, and time-consuming clerical tasks. These burdens take time away from meaningful patient interactions and clinical decision-making. At Huntington Hospital, clerical workload, especially tasks related to electronic health records (EHRs) and manual documentation, was identified as a key source of stress. To better understand the contributors to burnout, the hospital administered the Maslach Burnout Inventory (MBI) to all hospitalists. The MBI evaluates emotional exhaustion, depersonalization, and reduced personal accomplishment, offering a comprehensive assessment of professional well-being. Method To address this issue, a multi-disciplinary wellness learning community was formed to identify and implement evidence-based strategies to support staff well-being. The hospitalist group unanimously chose to focus on improving the workflow for the 3122 form, a handwritten discharge document required for patients transitioning to assisted living facilities. This form included evaluations of Activities of Daily Living (ADLs), therapy needs, home care requirements, and a medication list-all of which had to be completed manually by physicians. After multiple discussions with social work, case management, and peer institutions, it was decided that social workers would complete the sections of the form within their scope, such as ADLs and support needs. Medication lists were printed directly from the electronic medical record (EMR) and attached to the form to improve accuracy and efficiency. Hospitalists reviewed the completed form before it was submitted. This new workflow was piloted on one unit, with interest quickly spreading to other teams. Results With an 83% response rate to the MBI among hospitalists (33 out of 40 hospitalists), results revealed that workload was the primary driver of burnout. Following the workflow redesign, a two-question survey was conducted with hospitalists to assess the impact of the intervention. The survey asked physicians whether removing the 3122 form as a physician task had decreased their workload and whether they supported further collaborations with the Wellness Learning Community. 76% of respondents (n=21) agreed or strongly agreed that the change reduced their workload. An equal percentage supported ongoing efforts with the Wellness Learning Community to develop future process improvements and well-being initiatives. Conclusion This project highlights how small, targeted workflow changes can have a meaningful impact on clinician well-being. By reducing administrative burden and aligning task responsibility with appropriate team members, physicians were able to redirect time and energy toward patient care. The shift from handwritten documentation to EMR-generated materials also improved efficiency and reduced the risk of transcription errors. Interdisciplinary collaboration played a key role in the project's success. By engaging social work, case management, and frontline providers in the process, the hospital was able to design a more sustainable and effective solution. Focusing on staff well-being through operational redesign promotes a more resilient, satisfied, and safer healthcare workforce.

摘要

引言

员工福祉是任何医疗保健组织框架中的关键要素。改善医疗服务提供者和员工的福祉日益被视为高质量护理的关键。医护人员的职业倦怠往往是由过多的行政要求、低效的工作流程和耗时的文书工作任务所驱动。这些负担占用了与患者进行有意义互动和临床决策的时间。在亨廷顿医院,文书工作量,尤其是与电子健康记录(EHR)和手工文档相关的任务,被确定为压力的关键来源。为了更好地了解职业倦怠的成因,医院对所有住院医师进行了马氏职业倦怠量表(MBI)测试。MBI评估情感耗竭、去个性化和个人成就感降低,全面评估职业福祉。

方法

为了解决这个问题,成立了一个多学科健康学习社区,以确定和实施基于证据的策略来支持员工福祉。住院医师团队一致选择专注于改进3122表格的工作流程,这是一份手写的出院文件,用于转至辅助生活设施的患者。该表格包括日常生活活动(ADL)评估、治疗需求、家庭护理要求和药物清单——所有这些都必须由医生手动完成。在与社会工作、病例管理和同行机构进行多次讨论后,决定由社会工作者完成表格中其职责范围内的部分,如ADL和支持需求。药物清单直接从电子病历(EMR)打印并附在表格上,以提高准确性和效率。住院医师在提交表格前对已完成的表格进行审核。这个新的工作流程在一个科室进行了试点,很快引起了其他团队的兴趣。

结果

住院医师对MBI的回复率为83%(40名住院医师中有33名回复),结果显示工作量是职业倦怠的主要驱动因素。在重新设计工作流程后,对住院医师进行了一项包含两个问题的调查,以评估干预措施的影响。调查询问医生,将3122表格从医生任务中移除是否减轻了他们的工作量,以及他们是否支持与健康学习社区进一步合作。76%的受访者(n = 21)同意或强烈同意这一改变减轻了他们的工作量。同样比例的人支持与健康学习社区继续努力,以制定未来的流程改进和福祉倡议。

结论

该项目突出了针对性的小工作流程改变如何能对临床医生的福祉产生有意义的影响。通过减轻行政负担并将任务责任与合适的团队成员相匹配,医生能够将时间和精力重新导向患者护理。从手写文档转向由EMR生成的材料也提高了效率并降低了转录错误的风险。跨学科合作在项目成功中发挥了关键作用。通过让社会工作、病例管理和一线医疗服务提供者参与这一过程,医院能够设计出一个更可持续、更有效的解决方案。通过运营重新设计关注员工福祉,可促进建立更有韧性、更满意且更安全的医疗保健 workforce。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e6c/12253977/023ba4fb0301/cureus-0017-00000085799-i01.jpg

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