HCA healthcare journal of medicine最新文献

{"title":"A Nation-Wide Survey of Program Directors at a Large Health Care Organization: Prevalence and Perceptions of Resident Wellness Activities.","authors":"Alexander W Marshburn, Gabrielle Riazi, Sabrina Menezes, Stephanie Ramirez, Gregory Guldner, Jessica C Wells, Jason T Siegel","doi":"10.36518/2689-0216.1808","DOIUrl":"10.36518/2689-0216.1808","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated wellness programs in a large hospital network to determine residency program directors' (PDs) perspectives on their wellness programs' state, including wellness prioritization, frequency of wellness activities, and wellness' influence on decision-making across organizational levels.</p><p><strong>Methods: </strong>In 2021, 211 PDs were sent surveys on program policies, program implementation frequency, perceptions of the administration's ability to prioritize wellness, funding sources, and perceptions of resident wellness' impact on decision-making.</p><p><strong>Results: </strong>Among 211 contacted programs, 148 surveys were completed (70.1%). The majority reported having wellness programs, committees, and funding. Fewer than 25% reported having a chief wellness officer. PDs perceived that fellow colleagues in their institution linked wellness to markers of institutional success to a greater extent than other available options (ie, Accreditation Council for Graduate Medical Education [ACGME] requirements, budgetary concerns, resident input, core faculty priorities, and education quality). Financial well-being was perceived as least connected to wellness. Perceptions of wellness were rated across 3 organizational levels: program, institution, and organization. Across all levels, ACGME requirements (31.0%-32.8%) and budgetary/financial concerns (21.9%-37.0%) were perceived as having the most significant influence on overall decision-making, whereas resident wellness was rated lower in influence (8.0%-12.2%). Most programs allowed residents to attend mental health appointments without using paid time off (87.9%) and while on duty (83.1%).</p><p><strong>Conclusion: </strong>The frequency of wellness activities varied greatly across programs. PDs reported challenges making resident self-care and personal development a priority and perceived resident wellness as having limited importance to decision-making at higher levels.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Voices: Cultivating a Supportive Network From the Women in Medicine and Health Care Symposium.","authors":"Rutuja D Bhalerao, Kyle Mefferd, Jocelyn A Limas","doi":"10.36518/2689-0216.1801","DOIUrl":"10.36518/2689-0216.1801","url":null,"abstract":"<p><p>Description There are many studies, some discussed in this article, that recognize the numerous issues faced by women in medicine and the health care field. In response to the prevalence of these challenges, Riverside Community Hospital's General Medical Education department organized the second Women in Medicine & Healthcare Symposium on November 17, 2023. The symposium featured a panel of women leaders addressing challenges, such as work-life balance, maternity leave, fertility concerns, and family planning. Personal stories and studies on gender bias and infertility shed light on the shared experiences of women physicians. The positive response prompted Riverside Community Hospital to view the event as the first step in creating a supportive community.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating Workplace Burnout Through Transformational Leadership and Employee Participation in Recovery Experiences.","authors":"John Pladdys","doi":"10.36518/2689-0216.1783","DOIUrl":"10.36518/2689-0216.1783","url":null,"abstract":"<p><p>Description Burnout is a complex organizational phenomenon that diminishes employee well-being and overall organizational productivity. Researchers propose that leadership style contributes to employees' well-being, which impacts employee productivity. Organizations and leaders must address the causes of burnout and promote techniques employees can use to mitigate burnout, such as employee participation in recovery experiences. Recovery experiences are non-work activities that create positive outlooks and restore the energy needed to focus on one's work. This literature review examines current research in employee recovery experiences, conservation of resource theory (COR), burnout, and transformational leadership theory. Studying burnout through the lens of COR shows how important resource gain and recovery activities are to healthy employees and their job performance within the organization. The research reviewed suggests that transformational and transactional leadership styles have higher probabilities of promoting employee participation in recovery experiences than passive avoidant leadership style. The literature consistently showed burnout as a significant organizational phenomenon negatively affecting productivity, employee well-being, and turnover rates. The literature revealed that mitigating burnout happens through participation in recovery experiences. The literature on leadership styles supports the assumption that leaders play a significant role in employee well-being, group identity, and organizational climate. Leaders who desire to mitigate employee burnout will benefit from research that links transformational leadership style behaviors and employee participation in recovery activities.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Heart of Residency.","authors":"Julia Fashner, Samantha Gionocchio","doi":"10.36518/2689-0216.1607","DOIUrl":"https://doi.org/10.36518/2689-0216.1607","url":null,"abstract":"<p><p>Description As part of wellness activities in 2023, our family medicine residents produced individual paintings. Samantha coalesced these 4 × 4 canvases to create this heart. The following quote is also poignant for those of us in family medicine.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout and Health Scores Among Residency Programs as an Indicator of Wellness.","authors":"Hannah Manzi, Jon Halling, Nayda Parisio Poldiak, Suzanne Perkins","doi":"10.36518/2689-0216.1839","DOIUrl":"10.36518/2689-0216.1839","url":null,"abstract":"<p><strong>Background: </strong>With long hours, significant responsibilities, and a heavy workload, residency can be an incredibly stressful experience. The aim of our study was to assess the impact of residency on mental health and wellness. A secondary aim was to determine if the post-graduate year (PGY) of the different residents impacted their mental health or ability to cope with the stressors of residency.</p><p><strong>Methods: </strong>Residents in anesthesiology, family medicine, internal medicine, and surgery were invited to complete a survey. The first portion of the survey had residents rank their mental health on a scale from 1 to 5. There was also a short-form answer portion, which collected suggestions on how to improve wellness. An analysis of variance was used to compare the means of 2 continuous outcome variables-Patient Health Questionnaire (PHQ) and burnout scores compared across specialties and post-graduate years. Burnout scores were measured using the Oldenburg Burnout Inventory. This survey was created and validated by psychology researchers to assess burnout based on the strongest indicators of burnout-emotional exhaustion and disengagement from work. The PHQ9 survey was chosen as it has a specificity of 91-94% and is a reliable method to screen for depression, a common companion to burnout.</p><p><strong>Results: </strong>PHQ9 scores were highest among surgery residents (7.2 ± 7.07), followed by anesthesia (6.59 ± 6.64), emergency medicine (5.57 ± 4.09), and internal medicine (4.82 ± 3.68). Scoring was also higher among PGY4-6 residents. Burnout scores were highest among surgery (37.8 ± 8.69) and anesthesia (38.17 ± 7.09) residents and among PGY4-6 residents. PGY4-6 residents had a mean burnout score of 38.55 ± 7.67 compared to 36.17 ± 8.69 among first-year residents. Similarly, the <i>P</i> value noted no significant difference among burnout scores across either specialty or year: .5930 and .8061.</p><p><strong>Conclusion: </strong>There was no significant difference among specialties or years in training among their subjective ratings of depression.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle Medicine for the Health Care Worker, Workplace, and Community Well-Being: A Butterfly Effect.","authors":"Karina Doucet, Nicholas D'Angelo","doi":"10.36518/2689-0216.1816","DOIUrl":"10.36518/2689-0216.1816","url":null,"abstract":"<p><p>Description Burnout is a prevalent and expensive problem in the US, and the National Plan For Health Workforce Well-Being included a goal to institutionalize well-being as a long-term value. Lifestyle Medicine (LM), an evidence-based practice using behavioral interventions to treat, prevent, and reverse certain chronic conditions, can achieve this goal. Implementing small changes in the workplace that support lifestyle medicine has a butterfly effect on both workplace and community well-being. Furthermore, the health of health care workers (HCWs) and patients improves, and health care costs decrease. This can be done with LM wellness programs or LM training for HCWs. LM wellness programs help the individual HCWs' and patients' well-being through the implementation of the 6 pillars of lifestyle medicine (nutrition, diet, stress reduction, social connection, avoiding/reducing toxins, restorative sleep) on an institutional level. LM initiatives, like LM training, help HCWs and their patients embark on this journey of optimal well-being, disease prevention, treatment, or reversal. Aligning policies to support evidence-based lifestyle changes that improve mood and stress reduction would support restorative rest, leaving HCWs less drained and allowing for more energy to be spent devoted to other lifestyle pillars. The Lifestyle Medicine Residency Curriculum is an example of an LM training program that leads to successful lifestyle change in residents' lives, improving their ability to coach patients. Finally, health care delivery that supports lifestyle medicine, such as shared medical appointments, is in alignment with the trend towards a value-based system for the improvement of public health.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Burnout and Enhancing Well-Being Among Academic Physicians: A Call for Future Research and Organizational Support.","authors":"Kelly D Holder, Sharon Y Lee, Fatima Zehra Raza, Laura R Stroud","doi":"10.36518/2689-0216.1742","DOIUrl":"10.36518/2689-0216.1742","url":null,"abstract":"<p><p>Description Burnout among academic physicians, who navigate multiple roles beyond the clinical environment, is a pressing issue. However, the factors driving burnout among academic physicians are not fully understood. Prior research has revealed differences in burnout dimensions between clinical and basic science faculty, but the impact of balancing research, education, and clinical demands on academic physicians is still unclear. This knowledge gap negatively affects the clinical, translational science, research, and medical education workforces and has particular implications for minoritized and marginalized groups working in academic medical centers. Creating a culture of well-being has been vital in addressing burnout. Further research is needed to explore the unique experiences and demands of academic physicians- particularly those from minoritized and marginalized backgrounds-and to develop effective strategies to promote well-being as they balance diverse roles and contexts. This commentary highlights gaps in understanding burnout among academic physicians and proposes guidelines for future research as well as strategies to improve well-being at academic medical centers.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning from Health Care Counselors' Perspectives on Health Care Worker Distress: A Qualitative Analysis.","authors":"Nancy Downs, Judy Davidson, Angela Haddad, Sidney Zisook","doi":"10.36518/2689-0216.1613","DOIUrl":"10.36518/2689-0216.1613","url":null,"abstract":"<p><strong>Background: </strong>Health care provider stress and emotional distress were well documented long before the COVID-19 pandemic, and there is growing data suggesting these have increased in response to the pandemic. The goal of this study was to take advantage of the unique experiences of licensed mental health (MH) clinicians working with health care trainees and clinicians before and during the pandemic to identify how this crisis affected both ongoing as well as new sources of stress. The Healer Education, Assessment and Referral Program (HEAR) provides MH screening, support, and MH referrals to ~19 000 health care students, trainees, staff, and faculty. Since its inception in 2009, the program has been staffed by 4 licensed counseling professionals who have worked both before and since the COVID-19 pandemic.</p><p><strong>Methods: </strong>Qualitative data obtained from semi-structured, 1-hour interviews and a follow-up 1-hour focus group with 4 HEAR counselors was analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Several preexisting stressors were amplified during the pandemic: financial concerns; long work hours; exposure to the suffering of illness, death, and dying; bullying; discordant values and moral distress; social inequities; individuals' lack of adaptive coping; and individuals' self-concept as a victim. New stressors included: health care demand greater than the workforce numbers and resources; caretaking for ill family/friends; homeschooling of children; social isolation; experiencing the COVID-19 crisis as a war, fire, or storm; fear of personal illness and death, especially before vaccines; and hopes of a cure with vaccines; followed by perceived opportunities for improvement in leadership response to staff concerns.</p><p><strong>Conclusion: </strong>Authentically responding to staff concerns/ideas, a patient and provider-centered health care culture, grief education and support, and attention to actionable stressors affecting providers' well-being are indicated to meet the amplified and new stressors triggered by the COVID-19 pandemic and sequelae.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomy Versus Independence: Implications for Resident and Faculty Engagement, Performance, and Well-Being.","authors":"Adam P Neufeld, C Scott Rigby","doi":"10.36518/2689-0216.1780","DOIUrl":"10.36518/2689-0216.1780","url":null,"abstract":"<p><p>Description Research shows that when educational leaders support their learners' autonomy, it positively impacts both parties. This is particularly important in graduate medical education (GME), given that there is a strong emphasis on resident performance, evaluation, and development. Unfortunately, GME faculty often misunderstand autonomy as the resident's desire for independence or \"freedom,\" when in fact it refers to the core psychological need to feel volitional and agentic. The distinction is important because volition is not synonymous with independence, and providing freedom can be at odds with strategies that provide true autonomy support. This, in turn, can contribute to the stress, maladjustment, and resident burnout that are already prevalent in medicine. To help remedy this issue, this paper provides an evidence-based guide for medical educators to distinguish autonomy from independence, with specific examples to help translate theory into practice to better support the well-being of the medical community.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Disruption of COVID-19 on Medical Education in Incoming Psychiatric Residents.","authors":"Steven Sprenger, Ashley Mahajan, Jeffrey Anderson, Napatkamon Ayutyanont, Jessica C Wells, Gregory Guldner","doi":"10.36518/2689-0216.1567","DOIUrl":"10.36518/2689-0216.1567","url":null,"abstract":"<p><strong>Background: </strong>In 2020, the global COVID-19 pandemic caused educational disruptions to many medical students nationally. Societal and hospital guidelines, including social distancing protocols, resulted in the cancellation or postponement of many elective procedures. A shortage in personal protective equipment also contributed to restrictions in clinical experiences for trainees. The purpose of this study was to determine resident-perceived preparedness in core clinical competencies and evaluate the disruptions to core clerkships.</p><p><strong>Methods: </strong>A survey was developed to assess self-perceptions of clinical competencies and disruptions to core clerkship experiences. It was distributed to 63 incoming psychiatric residents who matched to training programs in the United States.</p><p><strong>Results: </strong>The survey response rate was 97%. The majority of respondents achieved self-expected levels of proficiency in clinical skills. Deficits were greatest for pelvic/rectal exams and transitions of care. Most students did not experience disruptions to clerkships. Internal medicine, obstetrics, and gynecology clerkships reported the highest rates of virtual completion. Procedures with the lowest reported perceived preparation were arterial puncture, airway management, and IV placement, respectively.</p><p><strong>Conclusion: </strong>Our survey results indicated that most learners did not perceive disruptions to their medical education and incoming psychiatry residents felt well-prepared to start residency. Some specific procedural skills appear to have been affected. Attempts to mitigate these specific inadequacies may help mitigate disruptions due to future events.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}