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AHRQ Research Studies Date
Topics
- Behavioral Health (1)
- (-) Burnout (19)
- Clinical Decision Support (CDS) (1)
- COVID-19 (1)
- Critical Care (1)
- Depression (1)
- Education: Continuing Medical Education (2)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Health Information Technology (HIT) (4)
- Hospitals (3)
- Intensive Care Unit (ICU) (1)
- Medication (1)
- Medication: Safety (1)
- Neonatal Intensive Care Unit (NICU) (1)
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- Nursing (1)
- Nursing Homes (1)
- Organizational Change (2)
- Patient Experience (1)
- Patient Safety (2)
- Primary Care (7)
- Provider (13)
- Provider: Clinician (4)
- Provider: Health Personnel (1)
- Provider: Nurse (4)
- Provider: Physician (7)
- Provider Performance (2)
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- Shared Decision Making (1)
- Stress (4)
- Teams (1)
- Workflow (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 19 of 19 Research Studies DisplayedCampbell AM, Mattoni M, Yefimov MN
Improving cognitive workload in radiation therapists: a pilot EEG neurofeedback study.
The authors employed an accelerated alpha-theta neurofeedback (NF) protocol to test if 12 radiation therapy therapists (RTTs) could learn the protocol and exhibit behavior and brain performance-related benefits. Following the 3-week protocol, participants showed a decrease in subjective cognitive workload and a decrease in response time during a performance task, as well as a decrease in desynchrony of the alpha electroencephalogram band. The authors concluded that the RTTs successfully learned the protocol and improved in perceived cognitive workload following 3 weeks of neurofeedback.
AHRQ-funded; HS025597.
Citation: Campbell AM, Mattoni M, Yefimov MN .
Improving cognitive workload in radiation therapists: a pilot EEG neurofeedback study.
Front Psychol 2020 Dec 3;11:571739. doi: 10.3389/fpsyg.2020.571739..
Keywords: Provider, Burnout, Stress, Workforce
Smith JG, Rogowski JA, Lake ET
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
Being unable to provide required nursing care to infants could contribute to poorer neonatal nurse job outcomes, which may exacerbate staffing challenges. Little evidence exists about how missed nursing care relates to neonatal nurse job outcomes. The purpose of this study was to determine relationships among missed nursing care, job enjoyment and intention to leave for neonatal nurses.
AHRQ-funded; HS024918.
Citation: Smith JG, Rogowski JA, Lake ET .
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
J Nurs Manag 2020 Nov;28(8):1940-47. doi: 10.1111/jonm.12943..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Provider: Nurse, Provider, Burnout, Nursing
Womack DM, Hribar MR, Steege LM
Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace.
Registered nurses (RNs) regularly adapt their work to ever-changing situations but routine adaptation transforms into RN strain when service demand exceeds staff capacity and patients are at risk of missed or delayed care. The purpose of this study was to assess the utility of ambient workplace data, defined as time-stamped transaction records and log file data produced by non-electronic health record care delivery tools (e.g., nurse call systems, communication devices), as an information channel for automated sensing of RN strain.
AHRQ-funded; HS026370.
Citation: Womack DM, Hribar MR, Steege LM .
Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace.
Appl Clin Inform 2020 Aug;11(4):598-605. doi: 10.1055/s-0040-1715829..
Keywords: Provider: Nurse, Provider, Health Information Technology (HIT), Workforce, Burnout
Co Z, Holmgren AJ, Classen DC
The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
This study evaluated the overall performance of hospitals that used the Computerized Physician Order Entry Evaluation Tool in 2017 and 2018 and compared performances for fatal orders and nuisance orders each year. The authors evaluated 1599 hospitals that took the test by using their overall percentage scores along with the percentage of fatal orders appropriately alerted on and the percentage of nuisance orders incorrectly alerted on. Overall hospital scores improved from 58.1% in 2017 to 66.2% in 2018. Fatal order performance improved slightly from 78.8% to 83.0%, but there no very little change in nuisance order performance (89.0% to 89.7%). Conclusions were that perhaps hospitals are not targeting the deadliest orders first and some hospitals may be achieving higher scores by over-alerting. This has the potential to cause clinician burnout and even worsen patient safety.
AHRQ-funded; HS023696.
Citation: Co Z, Holmgren AJ, Classen DC .
The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
J Am Med Inform Assoc 2020 Aug;27(8):1252-58. doi: 10.1093/jamia/ocaa098..
Keywords: Medication: Safety, Medication, Patient Safety, Clinical Decision Support (CDS), Shared Decision Making, Burnout, Hospitals, Health Information Technology (HIT), Quality of Care
Poghosyan L, Ghaffari A, Liu J
Organizational support for nurse practitioners in primary care and workforce outcomes.
Lack of organizational support in healthcare settings has been linked to high levels of clinician stress, burnout, and job dissatisfaction. Little research exists on organizational support for nurse practitioners. In this study, the researchers investigated the relationship between organizational support and nurse practitioner outcomes, including job satisfaction, intent to leave, and quality of care. The investigators concluded that nurse practitioners from primary care practices with higher levels of organizational support were more likely to be satisfied with their jobs, have less intent to leave their jobs, and report better quality of care.
AHRQ-funded; HS024758.
Citation: Poghosyan L, Ghaffari A, Liu J .
Organizational support for nurse practitioners in primary care and workforce outcomes.
Nurs Res 2020 Jul/Aug;69(4):280-88. doi: 10.1097/nnr.0000000000000425..
Keywords: Provider: Clinician, Provider, Primary Care, Burnout, Stress, Workforce, Organizational Change
Bansal P, Bingemann TA, Greenhawt M
Clinician wellness during the COVID-19 pandemic: extraordinary times and unusual challenges for the allergist/immunologist.
This article describes current challenges for the allergy/immunology community due to the COVID-19 pandemic. The need for social distancing adds to complexity of care and can create isolation and anxiety. The authors suggests that tools such as the Strength-Focused and Meaning-Oriented Approach to Resilience and Transformation approach, wellness apps, mindfulness and gratitude can be used to help reduce issues contributing to burnout, depression, anxiety, substance abuse, and posttraumatic stress disorder.
AHRQ-funded; HS024599.
Citation: Bansal P, Bingemann TA, Greenhawt M .
Clinician wellness during the COVID-19 pandemic: extraordinary times and unusual challenges for the allergist/immunologist.
J Allergy Clin Immunol Pract 2020 Jun;8(6):1781-90.e3. doi: 10.1016/j.jaip.2020.04.001..
Keywords: COVID-19, Burnout, Stress, Provider: Clinician, Provider: Physician
Goldberg DG, Soylu TG, Grady VM
Indicators of workplace burnout among physicians, advanced practice clinicians, and staff in small to medium-sized primary care practices.
The goal of this study was to examine whether individual behaviors and attitudes towards major disruptive change has an effect on workplace burnout. Using surveys from healthcare professionals, researchers’ findings showed workplace burnout reported by 31.6% of physicians, 17.2% of advanced practice clinicians, 18.9% of clinical support staff, and 17.5% of administrative staff, with all healthcare professional groups having high levels of anxiety. Providers who experienced higher levels of anxiety and withdrawal were more than three times as likely to report burnout compared to those who experienced low levels in these domains.
AHRQ-funded; HS023913.
Citation: Goldberg DG, Soylu TG, Grady VM .
Indicators of workplace burnout among physicians, advanced practice clinicians, and staff in small to medium-sized primary care practices.
J Am Board Fam Med 2020 May-Jun;33(3):378-85. doi: 10.3122/jabfm.2020.03.190260..
Keywords: Burnout, Primary Care, Provider, Workflow, Workforce
Adler-Milstein J, Zhao W, Willard-Grace R
Electronic health records and burnout: time spent on the electronic health record after hours and message volume associated with exhaustion but not with cynicism among primary care clinicians
This study examined whether objective measures of electronic health record (EHR) use-related to time, volume of work, and proficiency are associated with either exhaustion or cynicism. The authors combined Maslach Burnout Inventory survey measures with objective, vendor-defined EHR use measures from log files. Data was collected from all primary care clinics of a large, urban medical academic center in early 2018. One-third of clinicians had high cynicism and 51% had high emotional exhaustion. The clinicians with the most exhaustion spent time using the EHR after hours.
AHRQ-funded; HS022241.
Citation: Adler-Milstein J, Zhao W, Willard-Grace R .
Electronic health records and burnout: time spent on the electronic health record after hours and message volume associated with exhaustion but not with cynicism among primary care clinicians
J Am Med Inform Assoc 2020 Apr;27(4):531-38. doi: 10.1093/jamia/ocz220..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Clinician, Provider: Physician, Provider, Primary Care
Corby S, Gold JA, Mohan V
A sociotechnical multiple perspectives approach to the use of medical scribes: a deeper dive into the scribe-provider interaction.
This study’s objective was examine the scribe-provider relationship at healthcare organizations. Scribes help providers with electronic health records to alleviate provider burnout and increase clinical efficiency. Participants in the study included 81 clinicians (30 providers, 27 scribes, and 24 administrators) across five sites. The analysis generated six subthemes: characteristics of an ideal scribe, characteristics of a good provider, provider variability, quality of the scribe-provider relationship, negative side of the relationship, and evaluation and supervision of scribes.
AHRQ-funded; HS025141.
Citation: Corby S, Gold JA, Mohan V .
A sociotechnical multiple perspectives approach to the use of medical scribes: a deeper dive into the scribe-provider interaction.
AMIA Annu Symp Proc 2020 Mar 4;2019:333-42..
Keywords: Burnout, Electronic Health Records (EHRs), Health Information Technology (HIT)
White EM, Aiken LH, Sloane DM
Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction.
The objective of this cross-sectional study was to examine the relationships between work environment, care quality, registered nurse (RN) burnout, and job dissatisfaction in nursing homes. In this study, the investigators linked 2015 RN4CAST-US nurse survey data with LTCfocus and Nursing Home Compare. They indicate that their results suggest that the work environment is an important area to target for interventions to improve care quality and nurse retention in nursing homes.
AHRQ-funded; HS000011.
Citation: White EM, Aiken LH, Sloane DM .
Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction.
Geriatr Nurs 2020 Mar-Apr;41(2):158-64. doi: 10.1016/j.gerinurse.2019.08.007..
Keywords: Elderly, Nursing Homes, Burnout, Provider: Nurse, Provider, Quality of Care, Provider Performance
Edwards ST, Marino M, Balasubramanian BA
Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices.
The purpose of this study was to examine the association between physician-, advanced practice clinician- and staff-reported burnout and specific structural, organizational, and contextual characteristics of smaller primary care practices. Results showed that burnout is prevalent among physicians, advanced practice clinicians, and staff in smaller primary care practices. Members of solo practices less commonly report burnout, while members of health system-owned practices and Federally Qualified Health Centers more commonly report burnout, suggesting that practice level autonomy may be a critical determinant.
AHRQ-funded; HS023940.
Citation: Edwards ST, Marino M, Balasubramanian BA .
Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices.
J Gen Intern Med 2018 Dec;33(12):2138-46. doi: 10.1007/s11606-018-4679-0..
Keywords: Burnout, Primary Care, Provider: Physician, Provider: Clinician, Provider
Aiken LH, Sloane DM, Barnes H
Nurses' and patients' appraisals show patient safety in hospitals remains a concern.
This study analyzed if there is a positive correlation between improvements of work environments for nurses and improvements in patient safety. A total of 535 hospitals in four large states at two points in time between 2005 and 2016 were studied. Survey data showed an improvement of work environment with 21% of study hospitals, and 7% had worse scores. For the hospitals with improved work environments, patients and nurses both reported high scores for patient safety indicators. For work environments which deteriorated, favorable patient safety grades went down 21%.
AHRQ-funded; HS022406.
Citation: Aiken LH, Sloane DM, Barnes H .
Nurses' and patients' appraisals show patient safety in hospitals remains a concern.
Health Aff 2018 Nov;37(11):1744-51. doi: 10.1377/hlthaff.2018.0711..
Keywords: Burnout, Hospitals, Patient Experience, Patient Safety, Provider: Nurse, Quality of Care, Quality Improvement
Cofer KD, Hollis RH, Goss L
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
The purpose of this study was to evaluate whether burnout was associated with emotional intelligence and job performance in surgical residents. The investigators found that burnout was present in surgery residents and was associated with emotional intelligence. There was no association of burnout with United States Medical Licensing Examination scores, American Board of Surgery In-Training Exam percentile, or surgical milestones. The investigators suggested that traditional methods of assessing resident performance may not be capturing burnout and strategies to reduce burnout should consider targeting emotional intelligence.
AHRQ-funded; HS023009.
Citation: Cofer KD, Hollis RH, Goss L .
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
J Surg Educ 2018 Sep - Oct;75(5):1171-79. doi: 10.1016/j.jsurg.2018.01.021..
Keywords: Burnout, Education: Continuing Medical Education, Provider, Provider: Physician, Provider Performance
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
Blechter B, Jiang N, Cleland C
Correlates of burnout in small independent primary care practices in an urban setting.
Little is known about the prevalence and correlates of burnout among providers who work in small independent primary care practices (< 5 providers). The authors conducted a cross-sectional analysis by using data collected from 235 providers practicing in 174 small independent primary care practices in New York City. The burnout rate was relatively low among their sample of providers compared with previous surveys that focused primarily on larger practices.
AHRQ-funded; HS023922.
Citation: Blechter B, Jiang N, Cleland C .
Correlates of burnout in small independent primary care practices in an urban setting.
J Am Board Fam Med 2018 Jul-Aug;31(4):529-36. doi: 10.3122/jabfm.2018.04.170360..
Keywords: Burnout, Provider: Health Personnel, Primary Care
Costa DK, Moss M
The cost of caring: emotion, burnout, and psychological distress in critical care clinicians.
This paper comments on emotion, burnout, and psychological distress in critical care clinicians. It stresses that the current management approaches for burnout and other forms of psychological distress are insufficient and discusses possibilities for improvement.
AHRQ-funded; HS024552.
Citation: Costa DK, Moss M .
The cost of caring: emotion, burnout, and psychological distress in critical care clinicians.
Ann Am Thorac Soc 2018 Jul;15(7):787-90. doi: 10.1513/AnnalsATS.201804-269PS..
Keywords: Burnout, Critical Care, Provider, Workforce
Huber MT, Ham SA, Qayyum M
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
Investigators used an experimental vignette to test associations between physician demographics, salary, and working with exemplary colleagues on the likelihood of preferring a new job among burned out and non-burned out physicians in various specialties. They found that, among burned out physicians, the opportunity for better salary and colleagues made them more likely to prefer a new job compared to non-burned out physicians, with change in salary associated with the greatest difference. They recommended focusing on improving physician-colleague relationships to improve job retention.
AHRQ-funded; HS000078.
Citation: Huber MT, Ham SA, Qayyum M .
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
J Gen Intern Med 2018 Jun;33(6):789-91. doi: 10.1007/s11606-018-4412-z..
Keywords: Burnout, Workforce, Provider: Physician, Provider
Hung DY, Harrison MI , Truong Q
AHRQ Author: Harrison MI
Experiences of primary care physicians and staff following lean workflow redesign.
The researchers examined the work experiences of primary care physicians and staff after implementing Lean-based workflow redesigns. They found that both physicians and nonphysician staff reported higher levels of engagement and teamwork after implementing redesigns. However, the subjects also experienced higher levels of burnout and perceptions of the workplace as stressful.
AHRQ-authored; AHRQ-funded; 290201000022I.
Citation: Hung DY, Harrison MI , Truong Q .
Experiences of primary care physicians and staff following lean workflow redesign.
BMC Health Serv Res 2018 Apr 10;18(1):274. doi: 10.1186/s12913-018-3062-5.
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Keywords: Primary Care, Workflow, Burnout, Organizational Change, Provider: Physician, Teams
Cuellar A, Krist AH, Nichols LM
Effect of practice ownership on work environment, learning culture, psychological safety, and burnout.
The researchers examined whether there are differences across practice ownership in self-reported work environment, a practice culture of learning, psychological safety, and burnout. They concluded that hospital ownership was associated with positive perceptions of practice work environment and lower burnout for staff relative to independent ownership, whereas clinicians in federally qualified health centers (FQHCs) perceive a more negative, less joyful work environment and burnout.
AHRQ-funded; HS023913.
Citation: Cuellar A, Krist AH, Nichols LM .
Effect of practice ownership on work environment, learning culture, psychological safety, and burnout.
Ann Fam Med 2018 Apr;16(Suppl 1):S44-s51. doi: 10.1370/afm.2198.
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Keywords: Primary Care, Burnout, Provider