Journal of hospital medicine最新文献

Background: Hospitals and patients rely on effective clinician communication. Asynchronous electronic secure messaging (SM) systems are a common way for hospitalists to communicate, but few studies have evaluated how hospitalists are navigating the adoption of SM and the benefits and challenges they are encountering.

Objectives: The objective of this study is to assess academic hospitalist perspectives on SM to guide future research and quality improvement initiatives.

Methods: This was a mixed methods study utilizing an embedded REDCap survey and six virtual semistructured focus groups. It took place during a Hospital Medicine ReEngineering Network Zoom meeting on October 13, 2023. Rapid qualitative methods were used to define major themes.

Results: There were 28 hospitalists and one patient representative across 24 separate academic institutions. There was a 71% survey completion rate (N = 20). SM was felt to be an effective and efficient communication modality but was associated with a large amount of multitasking and interruptions. Perspectives around SM clustered around three main themes: SM has been widely but variably adopted; there is a lack of institutional guidance about how to best engage with SM; and SM is changing the landscape of hospitalist work by increasing ease but decreasing depth of communication, increasing cognitive load, and changing interpersonal relationships. Recommendations for SM improvements included the need for institutions to work with frontline workers to develop and implement clear usage guidelines.

Conclusion: SM is likely contributing to both positive and negative effects for clinicians and patients. Understanding hospitalist perspectives on SM will help guide future research and quality improvement initiatives.

Background: Hospital medicine is the largest growing specialty in the United States. It is important to understand factors that are related to burnout and work well-being (WWB), both predictors of workforce retention.

Objective: To examine the relationship between work environment factors and hospitalist burnout and WWB.

Methods: An online cross-sectional survey was completed by hospitalists in July-October 2020. Burnout was assessed using the Mini-Z burnout scale and the Abbreviated Maslach Burnout Inventory. WWB was assessed using the Work Well-Being Scale. Work structure variables included hours worked per week, frustration at work, safety level of clinical workload, lack of control over schedule, lack of control over daily work, continuity of patient care, and ability to optimize license. The current desire to practice medicine was also examined.

Results: Eight-eight hospitalists participated. There were statistically significant differences between levels of safety of workload (F(2,85) = 9.70, p = <.005), frustration at work (F(2,85) = 12.29, p = <.005), control over schedule (F(2,85) = 3.17, p = .04), control over daily work (F(2,85) = 6.17, p = .003), and desire to practice medicine (F(2,85) = 42.34, p = <.005) with WWB. There were statistically significant associations between the presence of burnout and the safety of workload (χ² = 8.167, p = .017), frustration at work (χ² = 15.29, p = .005), control over daily work (χ² = 12.48, p = .002), and desire to practice medicine (χ² = 7.12, p = .03). WWB was positively associated with years as a hospitalist (r = .249, p = .02)).

Conclusion: Work environment factors are associated with WWB and burnout. Modifiable work environment factors may offer a point of intervention for reducing burnout and enhancing WWB among hospitalists.