Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians

Ryan Sterling; Seppo T Rinne; Ashok Reddy; Megan Moldestad; Peter Kaboli; Christian D Helfrich; Nora B Henrikson; Karin M Nelson; Catherine Kaminetzky; Edwin S Wong

doi:10.1007/s11606-021-07006-x

Back

Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians

Journal article

Open access

Peer reviewed

Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians

Ryan Sterling, Seppo T Rinne, Ashok Reddy, Megan Moldestad, Peter Kaboli, Christian D Helfrich, Nora B Henrikson, Karin M Nelson, Catherine Kaminetzky and Edwin S Wong

Journal of general internal medicine : JGIM, Vol.37(1), pp.87-94

01/2022

DOI: 10.1007/s11606-021-07006-x

PMCID: PMC8321506

PMID: 34327656

Files and links (1)

url

https://doi.org/10.1007/s11606-021-07006-xView

Published (Version of record) Open Access

Abstract

Observational study Burnout, or job-related stress, affects more than half of all US physicians, with primary care physicians (PCPs) experiencing some of the highest rates in medicine. Our study analyzes national survey data to identify and prioritize workplace climate predictors of burnout among PCPs within a large integrated health system. Observational study of annual survey data from the Veterans Health Administration (VHA) All Employee Survey (AES) for 2013-2017. AES response rate ranged from 56 to 60% during the study period. Independent and dependent variables were measured from separate random samples. In total, 8,456 individual-level responses among PCPs at 110 VHA practice sites were aggregated at the facility level by reporting year. We used the semi-automated LASSO procedure to identify workplace climate measures that were more influential in predicting burnout and assessed relative importance using the Shapely value decomposition. VHA employees that self-identify as PCPs. Dependent variables included two dichotomous measures of burnout: emotional exhaustion and depersonalization. Independent measures included 30 survey measures related to dimensions of workplace climate (e.g., workload, leadership, satisfaction). We identified seven influential workplace climate predictors of emotional exhaustion and nine predictors of depersonalization. With few exceptions, higher agreement/satisfaction scores for predictors were associated with a lower likelihood of burnout. The majority of explained variation in emotional exhaustion was attributable to perceptions of workload (32.6%), organization satisfaction (28.2%), and organization support (19.4%). The majority of explained variation in depersonalization was attributable to workload (25.3%), organization satisfaction (22.9%), and connection to VHA mission (20.7%). Identifying the relative importance of workplace climate is important for the allocation of health organization resources to mitigate and prevent burnout within the PCP workplace. In a context of limited resources, efforts to reduce perceived workload and improve organization satisfaction may represent the biggest leverage points for health organizations to address physician burnout.

physician burnout

healthcare workforce

workplace climate

Details

Title: Subtitle: Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians
Creators: Ryan Sterling - Center for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA. ryan.sterling@va.gov
Seppo T Rinne - VA Center for Healthcare Organization and Implementation Research, Bedford, MA, USA
Ashok Reddy - Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle, WA, USA
Megan Moldestad - Center for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA
Peter Kaboli - University of Iowa, Internal Medicine
Christian D Helfrich - Department of Health Services, University of Washington, Seattle, WA, USA
Nora B Henrikson - Kaiser Permanente Washington, Seattle, WA, USA
Karin M Nelson - Center for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA
Catherine Kaminetzky - Center for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA
Edwin S Wong - Department of Health Services, University of Washington, Seattle, WA, USA
Resource Type: Journal article
Publication Details: Journal of general internal medicine : JGIM, Vol.37(1), pp.87-94
DOI: 10.1007/s11606-021-07006-x
PMID: 34327656
PMCID: PMC8321506
NLM abbreviation: J Gen Intern Med
ISSN: 0884-8734
eISSN: 1525-1497
Grant note: IK2 HX002248 / HSRD VA 15-363 / VA
Language: English
Date published: 01/2022
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9984210521402771

Metrics

15 Record Views

17 Times Cited - Web of Science