Physician and Nurse Well-Being and Preferred Interventions to Address Burnout in Hospital Practice
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Published:2023-07-07
Issue:7
Volume:4
Page:e231809
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ISSN:2689-0186
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Container-title:JAMA Health Forum
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language:en
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Short-container-title:JAMA Health Forum
Author:
Aiken Linda H.1, Lasater Karen B.1, Sloane Douglas M.1, Pogue Colleen A.1, Fitzpatrick Rosenbaum Kathleen E.1, Muir K. Jane1, McHugh Matthew D.1, Cleary Meagan2, Ley Cathaleen2, Borchardt Carla J.2, Brant Jeannine M.2, Turner Barbra L2, Leimberger Alyssa E.2, Kozlowski Kristin2, Coleman Bernice L.2, Albert Nancy M.2, Stewart Caroline2, Steele Dinah2, Kaplow Roberta2, Kaminsky Kathleen2, Hinkle Heidi A.2, Besa Rocel D.2, Taylor Kathleen P2, Dimino Kimberly2, Cetnar Cecelia2, Leach LS2, Albritton Sandra L.2, Davidson Carolyn L.2, Carrigan Timothy2, Burke Debra A.2, Anthony Kristin R.2, Kowalski Mildred O.2, Rounds Martha2, Tudor Jennifer M.2, Griffis Leigh2, Vassallo Linda M.2, Mulligan Marie2, Macyk Irene2, Manley-Cullen Catherine2, Hutchinson Sandra L.2, Haberman Amanda E.2, Barnard Amy L.2, Gobel Barbara H.2, McMahon Diana L.2, Brown Megan J.2, Strack Lisa2, Emmerling Sheryl A.2, Coladonato Angela R.2, Reich Jessie A.2, Gavaghan Justin J.2, Ballinghoff James R.2, Vanek Florence D.2, Book Karyn A.2, Easter Kathy2, Duchene Pamela2, Lough Mary E.2, Benson Christine L.2, Ducharme Maria2, Quinn Paul2, Molyneaux Donna M.2, Kennedy Lori2, Nyheim Elizabeth Ellen2, Grochow Donna M.2, Purcell Shannon M.2, Hanrahan Kirsten2, Isaacs Kathy B.2, Whade Jill J.2,
Affiliation:
1. Center for Health Outcomes and Policy Research, School of Nursing, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia 2. for the US Clinician Wellbeing Study Consortium
Abstract
ImportanceDisruptions in the hospital clinical workforce threaten quality and safety of care and retention of health professionals. It is important to understand which interventions would be well received by clinicians to address the factors associated with turnover.ObjectivesTo determine well-being and turnover rates of physicians and nurses in hospital practice, and to identify actionable factors associated with adverse clinician outcomes, patient safety, and clinicians’ preferences for interventions.Design, Setting, and ParticipantsThis was a cross-sectional multicenter survey study conducted in 2021 with 21 050 physicians and nurses at 60 nationally distributed US Magnet hospitals. Respondents described their mental health and well-being, associations between modifiable work environment factors and physician and nurse burnout, mental health, hospital staff turnover, and patient safety. Data were analyzed from February 21, 2022, to March 28, 2023.Main Outcomes and MeasuresClinician outcomes (burnout, job dissatisfaction, intent to leave, turnover), well-being (depression, anxiety, work-life balance, health), patient safety, resources and work environment adequacy, and clinicians’ preferences for interventions to improve their well-being.ResultsThe study sample comprised responses from 15 738 nurses (mean [SD] age, 38.4 [11.7] years; 10 887 (69%) women; 8404 [53%] White individuals) practicing in 60 hospitals, and 5312 physicians (mean [SD] age, 44.7 [12.0] years; 2362 [45%] men; 2768 [52%] White individuals) practicing in 53 of the same hospitals, with an average of 100 physicians and 262 nurses per hospital and an overall clinician response rate of 26%. High burnout was common among hospital physicians (32%) and nurses (47%). Nurse burnout was associated with higher turnover of both nurses and physicians. Many physicians (12%) and nurses (26%) rated their hospitals unfavorably on patient safety, reported having too few nurses (28% and 54%, respectively), reported having a poor work environment (20% and 34%, respectively), and lacked confidence in management (42% and 46%, respectively). Fewer than 10% of clinicians described their workplace as joyful. Both physicians and nurses rated management interventions to improve care delivery as more important to their mental health and well-being than interventions directed at improving clinicians’ mental health. Improving nurse staffing was ranked highest among interventions (87% of nurses and 45% of physicians).Conclusions and RelevanceThis cross-sectional survey study of physicians and nurses practicing in US Magnet hospitals found that hospitals characterized as having too few nurses and unfavorable work environments had higher rates of clinician burnout, turnover, and unfavorable patient safety ratings. Clinicians wanted action by management to address insufficient nurse staffing, insufficient clinician control over workload, and poor work environments; they were less interested in wellness programs and resilience training.
Publisher
American Medical Association (AMA)
Subject
Public Health, Environmental and Occupational Health,Health Policy
Cited by
91 articles.
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