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Topics
- (-) Burnout (16)
- Clinical Decision Support (CDS) (1)
- COVID-19 (2)
- Education: Curriculum (1)
- Elderly (1)
- Electronic Health Records (EHRs) (3)
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- Provider: Clinician (4)
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- Provider: Nurse (3)
- Provider: Physician (6)
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- Simulation (1)
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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 16 of 16 Research Studies DisplayedSexton JB, Adair KC, Cu X
Effectiveness of a bite-sized web-based intervention to improve healthcare worker wellbeing: a randomized clinical trial of WISER.
The purpose of this randomized controlled trial was to test the effectiveness of the Web-based Implementation for the Science of Enhancing Resilience (WISER) intervention, a positive psychology program constructed to improve six dimensions of the wellbeing of healthcare workers (HCW). The researchers utilized cohorts comprised of actively employed HCWs across the United States: cohort 1 received WISER web-based intervention in the form of links daily for 10 days exposing them to videos and positive psychology exercises; cohort 2 served as a 14-day waiting list control before receiving the same. The study found that at 1 week, when compared to the control group, WISER significantly improved depressive symptoms, work-life integration, happiness, emotional thriving, and emotional recovery, but not emotional exhaustion. Results of the combined cohort 1, 6, and 12 months revealed that all 6 wellbeing outcomes were significantly improved relative to the baseline. At the 6-month assessment, 87% of partifipants reported favorable impressions of WISER.
AHRQ-funded; HS027837.
Citation: Sexton JB, Adair KC, Cu X .
Effectiveness of a bite-sized web-based intervention to improve healthcare worker wellbeing: a randomized clinical trial of WISER.
Front Public Health 2022 Dec 8; 10:1016407. doi: 10.3389/fpubh.2022.1016407..
Keywords: Provider: Health Personnel, Burnout, Stress
Cardell CF, Yuce TK, Zhan T
What they are not telling us: analysis of nonresponders on a national survey of resident well-being.
The objective of this study was to characterize nonrespondents to a national survey about trainee well-being, and to examine patterns of responses to questions of a sensitive nature and assess how nonresponse biases estimates of mistreatment and well-being. The survey was administered with 2018 and 2019 American Board of Surgery In-Training Examinations and assessed demographics, dissatisfaction with education/career, mistreatment, burnout, thoughts of attrition, and suicidality. Overall response rates are high for this survey, but non-White or Hispanic residents were more likely to skip questions about racial/ethnic discrimination than White, non-Hispanic residents. Women were not more likely to omit questions regarding gender, gender identity, or sexual orientation discrimination. Prevalence estimates of burnout, suicidality, and gender discrimination were likely to be minimally impacted by nonresponse.
AHRQ-funded; HS025752.
Citation: Cardell CF, Yuce TK, Zhan T .
What they are not telling us: analysis of nonresponders on a national survey of resident well-being.
Ann Surg Open 2022 Dec; 3(4):e228. doi: 10.1097/as9.0000000000000228..
Keywords: Provider: Physician, Burnout
Livaudais M, Deng D, Frederick T
Perceived value of the electronic health record and its association with physician burnout.
The objective of this study was to investigate how seniority/years of practice, gender, and screened burnout status were associated with opinions of electronic health record (EHR) use on quality, cost, and efficiency of care. Ambulatory primary care and subspecialty clinicians at three different institutions were surveyed. Findings showed that burnout status was significantly associated with clinicians' perceived value of EHR technologies, while years of practice and gender were not.
AHRQ-funded; HS022065.
Citation: Livaudais M, Deng D, Frederick T .
Perceived value of the electronic health record and its association with physician burnout.
Appl Clin Inform 2022 Aug;13(4):778-84. doi: 10.1055/s-0042-1755372..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Burnout, Provider: Physician
Kerrissey M, Tietschert M, Novikov Z
Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration.
The purpose of this study was to explore the social features of health system integration -elements of normative integration (alignment of norms) and interpersonal integration (collaboration among professionals and with patients). The researchers administered surveys to practice managers and 1,360 staff and physicians at 59 practice sites within 17 health systems, with a 61% response rate of 828. The study found that the variables of normative and interpersonal integration were both consistently related to better provider experience, perceived care quality, and clinical integration. Variance in social features of integration may help explain why some health systems are better at integrating care, highlighting normative and interpersonal integration as possible resources for improvement.
AHRQ-funded; HS024067.
Citation: Kerrissey M, Tietschert M, Novikov Z .
Social features of integration in health systems and their relationship to provider experience, care quality and clinical integration.
Med Care Res Rev 2022 Jun; 79(3):359-70. doi: 10.1177/10775587211024796..
Keywords: Burnout, Provider: Physician, Health Systems
Evans LV, Ray JM, Bonz JW
Improving patient and clinician safety during COVID-19 through rapidly adaptive simulation and a randomised controlled trial: a study protocol.
The purpose of this study will be to simultaneously assess the challenges and facilitators of COVID-19 preparedness in the emergency department (ED) and the mitigation of emergency physician stress, test the effectiveness of a simulation preparedness intervention on physician physiological stress, and improve physician preparedness while decreasing physician stress and anxiety.
AHRQ-funded; HS028340.
Citation: Evans LV, Ray JM, Bonz JW .
Improving patient and clinician safety during COVID-19 through rapidly adaptive simulation and a randomised controlled trial: a study protocol.
BMJ Open 2022 May 19;12(5):e058980. doi: 10.1136/bmjopen-2021-058980..
Keywords: COVID-19, Patient Safety, Simulation, Burnout, Provider: Clinician
Fraiman YS, Cheston CC, Cabral HJ
Effect of a novel mindfulness curriculum on burnout during pediatric internship: a cluster randomized clinical trial.
This study examined the effectiveness of a monthly mindfulness curriculum (Mindfulness Intervention for New Interns) for medical interns on emotional exhaustion (EE) as measured by the Maslach Burnout Inventory 9-question EE subscale as well as secondary outcomes of depersonalization, personal accomplishment, and burnout. This was a randomized clinical trial of 340 pediatric interns participating in 15 US pediatric training programs from June 2017 to February 2019. The intervention included 7 hour-long sessions and a monthly mindfulness refresher implemented during internship. The active control arm also included monthly 1-hour social lunches. Follow-up was done at 6 months and at month 15. Both arms’ EE scores were higher at 6 and 15 months than at baseline, but EE did not significantly differ by arm in multivariable analyses. There were also no significant differences in the 6 secondary outcomes at month 6 or month 15.
AHRQ-funded; HS000063.
Citation: Fraiman YS, Cheston CC, Cabral HJ .
Effect of a novel mindfulness curriculum on burnout during pediatric internship: a cluster randomized clinical trial.
JAMA Pediatr 2022 Apr;176(1):365-72. doi: 10.1001/jamapediatrics.2021.5740..
Keywords: Education: Curriculum, Burnout, Provider: Physician
Campbell 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