Two-year Results of an Emergency Department Night Shift Buy-out Program.

IF 1.8 3区 医学 Q2 EMERGENCY MEDICINE
Charlotte W Croteau, Joshua N Goldstein, Lauren Nentwich, Ali S Raja, Michael VanRooyen, Joshua J Baugh
{"title":"Two-year Results of an Emergency Department Night Shift Buy-out Program.","authors":"Charlotte W Croteau, Joshua N Goldstein, Lauren Nentwich, Ali S Raja, Michael VanRooyen, Joshua J Baugh","doi":"10.5811/westjem.20303","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Emergency physicians have the highest rates of burnout among our physician peers, with prior literature suggesting clinician schedules can play a significant role in burnout. We assessed our transition from a tenure- and age-based paradigm to an egalitarian, night shift buy-out program that allows schedule flexibility for physicians at all stages of their careers.</p><p><strong>Methods: </strong>The night shift buy-out program was implemented in the emergency department (ED) of an academic, quaternary-care center that treats approximately 100,000 adult patients annually with 56 faculty emergency physicians. We sought to create a cost-neutral program, carefully balancing incentives between nocturnists and those wanting to reduce allotted night shifts. Ultimately, the program was designed to allow all faculty to buy out of any number of nights for $500 per night shift, with the funds generated used to increase nocturnist salaries. We analyzed two years of the program (July 2022-June 2024) to assess trends in night shift buy-outs, the primary outcome. We also conducted an all-faculty survey after the program's first year to gauge sentiments about the program.</p><p><strong>Results: </strong>Over two years, 22 faculty (42%) fully bought out of nights; an additional 10 (15%) bought out of some nights. By year two, the program could grant all faculty their preferred night-shift allotment. Faculty who bought out fully had worked longer in EM on average, worked fewer clinical hours per year, were more likely to be associate/full professors, and were less likely to be women. Nocturnists had the highest mean clinical hours of the four groups, had the lowest average tenure, and were least likely to be associate/full professors. A total of 86% of faculty responded to the survey, to which more than 80% of those buying out reported that reducing the night-shift burden was either \"very important\" or \"critical for continuing in this job.\"</p><p><strong>Conclusion: </strong>Our academic ED transitioned from a tenure- and age-based, overnight shift paradigm to an egalitarian buy-out program that allows physicians flexibility at all career stages. This approach could improve career satisfaction and reduce burnout among emergency physicians.</p>","PeriodicalId":23682,"journal":{"name":"Western Journal of Emergency Medicine","volume":"26 2","pages":"290-294"},"PeriodicalIF":1.8000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931706/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Western Journal of Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5811/westjem.20303","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Emergency physicians have the highest rates of burnout among our physician peers, with prior literature suggesting clinician schedules can play a significant role in burnout. We assessed our transition from a tenure- and age-based paradigm to an egalitarian, night shift buy-out program that allows schedule flexibility for physicians at all stages of their careers.

Methods: The night shift buy-out program was implemented in the emergency department (ED) of an academic, quaternary-care center that treats approximately 100,000 adult patients annually with 56 faculty emergency physicians. We sought to create a cost-neutral program, carefully balancing incentives between nocturnists and those wanting to reduce allotted night shifts. Ultimately, the program was designed to allow all faculty to buy out of any number of nights for $500 per night shift, with the funds generated used to increase nocturnist salaries. We analyzed two years of the program (July 2022-June 2024) to assess trends in night shift buy-outs, the primary outcome. We also conducted an all-faculty survey after the program's first year to gauge sentiments about the program.

Results: Over two years, 22 faculty (42%) fully bought out of nights; an additional 10 (15%) bought out of some nights. By year two, the program could grant all faculty their preferred night-shift allotment. Faculty who bought out fully had worked longer in EM on average, worked fewer clinical hours per year, were more likely to be associate/full professors, and were less likely to be women. Nocturnists had the highest mean clinical hours of the four groups, had the lowest average tenure, and were least likely to be associate/full professors. A total of 86% of faculty responded to the survey, to which more than 80% of those buying out reported that reducing the night-shift burden was either "very important" or "critical for continuing in this job."

Conclusion: Our academic ED transitioned from a tenure- and age-based, overnight shift paradigm to an egalitarian buy-out program that allows physicians flexibility at all career stages. This approach could improve career satisfaction and reduce burnout among emergency physicians.

求助全文
约1分钟内获得全文 求助全文
来源期刊
Western Journal of Emergency Medicine
Western Journal of Emergency Medicine Medicine-Emergency Medicine
CiteScore
5.30
自引率
3.20%
发文量
125
审稿时长
16 weeks
期刊介绍: WestJEM focuses on how the systems and delivery of emergency care affects health, health disparities, and health outcomes in communities and populations worldwide, including the impact of social conditions on the composition of patients seeking care in emergency departments.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信