The Work-life Check-ins randomized controlled trial: A leader-based adaptive, semi-structured burnout intervention in primary care clinics

IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Contemporary clinical trials Pub Date : 2024-06-13 DOI:10.1016/j.cct.2024.107609
David A. Hurtado , Jacqueline Boyd , Rachel Madjlesi , Samuel A. Greenspan , David Ezekiel-Herrera , Gideon Potgieter , Leslie B. Hammer , Teresa Everson , Abigail Lenhart
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Abstract

Background

Burnout in primary care undermines worker well-being and patient care. Many factors contribute to burnout, including high workloads, emotional stress, and unsupportive supervisors. Formative evidence suggests that burnout might be reduced if clinic leaders hold quarterly and brief (∼30 min) one-on-one check-ins with team members to acknowledge and address work-life stressors (e.g., schedules, workflow breakdowns, time off requests). This paper describes the intervention protocol for a randomized controlled trial (RCT) designed to evaluate the effectiveness and process of the check-ins in reducing burnout among primary care professionals.

Methods

Two-arm RCT conducted at 12 primary care clinics of a healthcare system in the Pacific Northwest. Six clinics received an adaptive design, semi-structured intervention, including predefined training modules with evidence-based tactics to reduce burnout through the check-ins, followed by clinic-specific feedback sessions prior to offering and conducting quarterly leader-employee check-ins. Six clinics were randomized as waitlist controls. Burnout was measured using the Maslach Burnout Inventory (MBI) at baseline and at the 12-month follow-up. Secondary outcomes include organizational constraints, psychological safety, and supervisor support. Multilevel modeling and qualitative methods were applied to evaluate the effects and process of the intervention.

Conclusion

By focusing on modifiable work-life factors such as stressors and supervisor support, the check-ins intervention aims to reduce burnout rates among primary care professionals. Findings from this trial will shed light on the conditions upon which check-ins might reduce burnout. Results will also inform policies and interventions aimed at improving mental health and well-being in primary care settings.

ClinicalTrials.gov: ID NCT05436548

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工作-生活签到随机对照试验:在初级保健诊所开展的基于领导者的适应性半结构化职业倦怠干预。
背景:初级保健中的职业倦怠损害了工作人员的福利和对患者的护理。导致职业倦怠的因素有很多,包括工作量大、情绪压力大、主管不支持等。形成性证据表明,如果诊所领导每季度与团队成员进行一次简短(约 30 分钟)的一对一检查,以确认并解决工作与生活压力(如日程安排、工作流程中断、请假要求),则可能会减少职业倦怠。本文介绍了一项随机对照试验(RCT)的干预方案,该试验旨在评估签到在减少初级保健专业人员职业倦怠方面的效果和过程:方法:在西北太平洋地区医疗保健系统的 12 家初级保健诊所开展两臂随机对照试验。六家诊所接受了适应性设计的半结构化干预,包括预先定义的培训模块,其中包含通过签到减少职业倦怠的循证策略,随后在提供和开展季度领导-员工签到之前进行针对特定诊所的反馈会议。六家诊所作为候补对照被随机分配。在基线和 12 个月的随访中使用马斯拉赫倦怠量表 (Maslach Burnout Inventory, MBI) 对倦怠进行测量。次要结果包括组织约束、心理安全和主管支持。多层次建模和定性方法被用来评估干预的效果和过程:通过关注压力因素和主管支持等可改变的工作与生活因素,签到干预旨在降低初级保健专业人员的职业倦怠率。这项试验的结果将阐明签到可以减少职业倦怠的条件。研究结果还将为旨在改善初级医疗机构心理健康和幸福感的政策和干预措施提供参考:id NCT05436548。
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来源期刊
CiteScore
3.70
自引率
4.50%
发文量
281
审稿时长
44 days
期刊介绍: Contemporary Clinical Trials is an international peer reviewed journal that publishes manuscripts pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from disciplines including medicine, biostatistics, epidemiology, computer science, management science, behavioural science, pharmaceutical science, and bioethics. Full-length papers and short communications not exceeding 1,500 words, as well as systemic reviews of clinical trials and methodologies will be published. Perspectives/commentaries on current issues and the impact of clinical trials on the practice of medicine and health policy are also welcome.
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