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PURPOSE: The issue of burnout has been identified as one of the most pressing challenges in organizational management, impacting the ability of an organization to succeed as well as employee productivity. In the healthcare industry, burnout is particularly prevalent. Burnout has received increasing attention from scholars, and different models have also been proposed to address this issue. However, burnout is on the rise in healthcare, especially in developing countries, indicating the need for more research on how to mitigate burnout. Research indicates that internal corporate social responsibility (ICSR) has a significant impact on employee behavior. However, little attention has been paid to exploring how ICSR might effectively reduce healthcare burnout. This study aims to investigate how ICSR and employee burnout are related in the healthcare sector of a developing country. In addition, we tested how subjective well-being and resilience mediate and moderate the effect of ICSR on employee burnout. METHODS: Data were collected from 402 healthcare employees working in different hospitals in Pakistan. In our study, we used a self-administered questionnaire as a data collection instrument. We have adapted the items in this survey from reliable and already published sources. Data collection was carried out in three waves. RESULTS: Hypotheses were evaluated using structural equation modeling (SEM). Software such as IBM-SPSS and AMOS were used for this purpose. ICSR significantly reduces healthcare employees’ burnout, according to the results of the structural analysis. The relationship between ICSR and burnout was also found to be mediated by subjective well-being, and resilience moderated the relationship between ICSR and subjective well-being. FINDINGS: In light of our findings, hospitals can take some important steps to resolve the problem of burnout. The study specifically stresses the importance of ICSR as a contextual organizational resource for preventing burnout among healthcare employees.

PURPOSE OF REVIEW: The study sought to assess the prevalence of physician burnout among interventional pain physicians in 2022. RECENT FINDINGS: Physician burnout is major psychosocial and occupational health issue. Prior to the coronavirus disease of 2019 (COVID-19) pandemic, over 60% of physicians reported emotional exhaustion and burnout. Physician burnout was reported to become more prevalent in multiple medical specialties during the COVID-19 pandemic. An 18-question survey was distributed electronically to all ASPN members (n = 7809) in the summer of 2022 to assess demographics, burnout characteristics (e.g., Have you felt burned out due to COVID?), and strategies to cope with burnout and stress (e.g., reached out for mental-health assistance). Members were able to complete the survey once and were unable to make changes to their responses once submitted. Descriptive statistics were used to assess the prevalence and severity of physician burnout within the ASPN community. Chi-square tests were used to examine differences in burnout by provider characteristics (age, gender, years practicing, and practice type) with p-values less than 0.05 indicating statistical significance. There were 7809 ASPN members that received the survey email, 164 of those members completed the survey, a response rate of 2.1%. The majority of respondents were male (74.1%, n = 120), 94% were attending physicians (n = 152), and 26% (n = 43) have been in practice for twenty years or longer. Most respondents expressed having experienced burnout during the COVID pandemic (73.5%, n = 119), 21.6% of the sample reported reduced hours and responsibilities during the pandemic, and 6.2% of surveyed physicians quit or retired due to burnout. Nearly half of responders reported negative impacts to their family and social lives as well as personal physical and mental health. A variety of negative (e.g., changes in diet, smoking/vaping) and positive coping strategies (e.g., exercise and training, spiritual enrichment) were employed in response to stress and burnout; 33.5% felt they should or had reached out for mental health assistance and suicidal ideations were expressed in 6.2% due to burnout. A high percentage of interventional pain physicians continue to experience mental symptoms that may lead to risk for significant issues going forward. Our findings should be interpreted with caution based on the low response rate. Evaluation of burnout should be incorporated into annual assessments given issues of survey fatigue and low survey response rates. Interventions and strategies to address burnout are warranted.

INTRODUCTION: Home visitor well-being is integral to delivering effective home visiting services and a core component of successful home visiting program implementation. While burnout (BO), compassion fatigue (CF), and compassion satisfaction (CS) have been studied extensively in physicians, nurses, and other health providers, little is known about the correlates of these phenomena in home visitors. METHODS: This cross-sectional study examined demographic characteristics (age, race, gender), health and personal experiences (anxiety, physical health, and adverse childhood experiences), and job-related factors (caseload, role certainty, job satisfaction) as correlates of BO, CF and CS among a sample of 75 home visitors employed across six MIECHV-funded agencies in New York State. Descriptive statistics were used to characterize our sample; linear regressions were employed to investigate correlates with outcomes of interest. RESULTS: Anxiety was significantly and positively associated with BO (??=?2.5, p?

IMPORTANCE: Emergency medicine (EM) physicians experience tremendous emotional health strain, which has been exacerbated during COVID-19, and many have taken to social media to express themselves. OBJECTIVE: To analyze social media content from academic EM physicians and resident physicians to investigate changes in content and language as indicators of their emotional well-being. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used machine learning and natural language processing of Twitter posts from self-described academic EM physicians and resident physicians between March 2018 and March 2022. Participants included academic EM physicians and resident physicians with publicly accessible posts (at least 300 total words across the posts) from the US counties with the top 10 COVID-19 case burdens. Data analysis was performed from June to September 2022. EXPOSURE: Being an EM physician or resident physician who posted on Twitter. MAIN OUTCOMES AND MEASURES: Social media content themes during the prepandemic period, during the pandemic, and across the phases of the pandemic were analyzed. Psychological constructs evaluated included anxiety, anger, depression, and loneliness. Positive and negative language sentiment within posts was measured. RESULTS: This study identified 471 physicians with a total of 198 867 posts (mean [SD], 11 403 [18 998] words across posts; median [IQR], 3445 [1100-11 591] words across posts). The top 5 prepandemic themes included free open-access medical education (Cohen d, 0.44; 95% CI, 0.38-0.50), residency education (Cohen d, 0.43; 95% CI, 0.37-0.49), gun violence (Cohen d, 0.37; 95% CI, 0.32-0.44), quality improvement in health care (Cohen d, 0.33; 95% CI, 0.27-0.39), and professional resident associations (Cohen d, 0.33; 95% CI, 0.27-0.39). During the pandemic, themes were significantly related to healthy behaviors during COVID-19 (Cohen d, 0.83; 95% CI, 0.77-0.90), pandemic response (Cohen d, 0.71; 95% CI, 0.65-0.77), vaccines and vaccination (Cohen d, 0.60; 95% CI, 0.53-0.66), unstable housing and homelessness (Cohen d, 0.40; 95% CI, 0.34-0.47), and emotional support for others (Cohen d, 0.40; 95% CI, 0.34-0.46). Across the phases of the pandemic, thematic content within social media posts changed significantly. Compared with the prepandemic period, there was significantly less positive, and concordantly more negative, language used during COVID-19. Estimates of loneliness, anxiety, anger, and depression also increased significantly during COVID-19. CONCLUSIONS AND RELEVANCE: In this cross-sectional study, key thematic shifts and increases in language related to anxiety, anger, depression, and loneliness were identified in the content posted on social media by academic EM physicians and resident physicians during the pandemic. Social media may provide a real-time and evolving landscape to evaluate thematic content and linguistics related to emotions and sentiment for health care workers.

Artificial intelligence (AI) is here to stay and will change health care as we know it. The availability of big data and the increasing numbers of AI algorithms approved by the US Food and Drug Administration together will help in improving the quality of care for patients and in overcoming human fatigue barriers. In oncology practice, patients and providers rely on the interpretation of radiologists when making clinical decisions; however, there is considerable variability among readers, and in particular for prostate imaging. AI represents an emerging solution to this problem, for which it can provide a much-needed form of standardization. The diagnostic performance of AI alone in comparison to a combination of an AI framework and radiologist assessment for evaluation of prostate imaging has yet to be explored. Here, we compare the performance of radiologists alone versus a combination of radiologists aided by a modern computer-aided diagnosis (CAD) AI system. We show that the radiologist-CAD combination demonstrates superior sensitivity and specificity in comparison to both radiologists alone and AI alone. Our findings demonstrate that a radiologist + AI combination could perform best for detection of prostate cancer lesions. A hybrid technology-human system could leverage the benefits of AI in improving radiologist performance while also reducing physician workload, minimizing burnout, and enhancing the quality of patient care. PATIENT SUMMARY: Our report demonstrates the potential of artificial intelligence (AI) for improving the interpretation of prostate scans. A combination of AI and evaluation by a radiologist has the best performance in determining the severity of prostate cancer. A hybrid system that uses both AI and radiologists could maximize the quality of care for patients while reducing physician workload and burnout.

[This is an excerpt.] Mentor relationships are a vital component to a professional career and are intended to promote personal growth and develop the best version of yourself. Many students develop these relationships prior to pharmacy school, and they continue for years. Mentor relationships are easy to cultivate and occur at all levels; upper classmen mentoring first year pharmacy students, residents mentoring externs, PGY2 residents mentoring PGY1 residents, and so on and so forth. Good mentor–mentee relationships tend to be organic and typically don’t require extensive preparation or research. So, is it normal as a mentor to feel burnout after years of these relationships? If these conversations are built upon 2 people sharing opinions, advise, experiences, and knowledge, why as a mentor do I feel burnout? [To read more, click View Resource.]

BACKGROUND: Nursing shortages have been an issue for decades; however, shortages have been on the rise in recent years. The COVID-19 pandemic only exacerbated the issue and brought to light many of the challenges that nurses are facing in the workforce. A common theme has been overworked nurses that are now experiencing burnout, which is causing them to take a break from nursing or leave the field permanently. OBJECTIVE: The aim of this research study is to understand if a lack of adequate breaks is causing a decrease in job satisfaction among nurses. METHODS: A quality improvement research study was conducted over 8 weeks and included 17 registered nurses. A 10-question survey was distributed via SurveyMonkey. DATA ANALYSIS: Microsoft Excel Data Analysis program and SurveyMonkey Analysis program were used for data analysis to quantify responses. RESULTS: Over 50% of the nurses surveyed do not have mandatory breaks during their 12-hour shifts. 94% of nurses are feeling some degree of burn out at their current jobs, with 76% of those nurses either contemplating leaving or undecided if they will leave. CONCLUSION: The survey was able to identify that most nurses working 12-hour shifts in an acute care setting do not get adequate breaks. The cause of the lack of breaks was not studied; however, it showed that almost all the nurses surveyed were feeling burned out and a little more than half are contemplating leaving their jobs. There was a significant amount that said receiving mandatory breaks during their shift would improve the burn out they are facing.

PURPOSE: This article assesses the prevalence of burnout among ophthalmology educators and identifies opportunities to improve well-being in this population. METHODS: The research team conducted a cross-sectional study using an institutional review board-exempt survey addressing the domains of the Maslach Burnout Inventory, intent to leave, and interest in wellness activities. Survey participants included ophthalmology residency program directors (PDs) and associate PDs (APDs) who are members of the Association of University Professors of Ophthalmology (AUPO). Analysis involved a top-box approach. RESULTS: Surveys were sent to 175 members with a response rate of 38.9%. Percentages of survey respondents reporting either (1) “never” or (2) “less than a few times per year” when asked to self-assess for certain manifestations of burnout are as follows: “considering residents as impersonal objects” (95.2%), “becoming more callous towards people” (90.3%), and “becoming emotionally hardened” (80.6%). Approximately 65% of ophthalmology educators reported never considering or rarely considering leaving their position in the year prior to completing the survey. For wellness promotion among AUPO educators, the greatest interest was in small group mentoring sessions (85%) and webinars on wellness-related topics (70%). CONCLUSION: The prevalence of burnout symptoms among ophthalmology educators compares favorably to educators from other specialties. Ophthalmology PDs and APDs demonstrate a greater degree of personal accomplishment than do their cohorts within other specialties, suggesting a decreased likelihood of burnout onset among ophthalmology educators. Furthermore, our study’s job satisfaction data reveal a high degree of satisfaction among ophthalmology PDs and APDs.

BACKGROUND: High burnout is reported among health professionals providing in-patient care to patients with coronavirus disease 2019 (COVID-19). Data are lacking on job stressors and burnout among health providers working in dedicated outpatient facilities for patients with suspected or confirmed COVID-19. METHODS: This cross-sectional study, using a parallel mixed-methods design, was carried out in 2021−2022 among 22 nurses and 22 primary-care physicians working at a COVID Outpatient Respiratory Center (CORC) (100% participation). Work conditions were assessed via the nurse- and physician-specific Occupational Stressor Index (OSI) and occupational records. Measures of the outcome included the Copenhagen Burnout Index and current tobacco use. RESULTS: Time working in CORC displayed significant multivariate associations with personal, work- and patient-related burnout among physicians and current tobacco use among nurses. Total OSI scores showed adjusted odds ratios for work-related (1.35 (1.01 ± 1.79))(1.31 (0.99 ± 1.75)) and patient-related burnout (1.35 (1.01 ± 1.81))(1.34 (1.01 ± 1.78)) among physicians and nurses, respectively. Numerous work stressors showed significant multivariate associations with burnout and smoking. Among the stressors were: being contacted outside work hours about patients, inadequate rest breaks, many patients/shifts, difficulty taking time off, insufficient pay, frequently listening to emotionally disturbing accounts, interruptions, increased workload, time pressure, and responsibility. Heavy patient burden/time pressure was most often cited as the hardest part of work in CORC. Increased employment of staff was the most frequently suggested workplace modification. Integrative assessment reveals that increased staff could ameliorate many work stressors associated with burnout and smoking in this cohort. CONCLUSIONS: Working in CORC is an extra burden. In crisis situations such as the COVID pandemic, more staff is needed. Lowering the total job stressor load is vital.

The prevalence of burnout among emergency physicians is among the highest of any specialty. Multiple studies have described factors that contribute to physician burnout, such as age, institutional support, and the electronic medical record (EMR). However, there have been few studies that investigate those physicians who are satisfied with their career and their personal lives. This qualitative study evaluated emergency physicians who were satisfied with both their career and personal lives to propose a model for physician well-being. Physicians were recruited using email solicitation and referral by their peers from June-September 2020. Inclusion criteria involved those physicians who were satisfied with their life and their job and did not meet the criteria for burnout. A qualitative, non-structured interview with open-ended questions was performed with each participant. Emergent themes were identified using standard practice for qualitative studies. Twenty-three physicians participated with a mean age of 45.4 years old (range 32–65), 17 (73.9%) were men, 13 (56.5%) were Caucasian, 6 (26.0%) were Asian/South Asian, 1 (4.3%) were Latino, and 3 (13.0%) were another ethnicity. Several important themes emerged. Physicians satisfied with their lives and their jobs tended to be personally resilient, socially connected, with significant outside interests. These physicians self-identified their personality type as having both introverted and extroverted features. Threats to thriving included ineffective leadership and the EMR. This project proposes a model for job and life satisfaction among emergency physicians. Encouraging these qualities, while fostering supportive leadership, and optimizing the EMR, may improve satisfaction among physicians experiencing burnout.

The COVID-19 pandemic has presented an array of novel issues for hospitals and their staff, 1 of the most noted being increased patient isolation due to visitation restrictions. This has created new challenges for health care systems and their workers. To leverage the expertise of Palliative Care Practitioners (PCP) as described here to improve patient/provider communication, patient experience, and quality of care during the COVID-19 pandemic. To address these new obstacles to patient care presented by the pandemic, a PCP was incorporated into the physician team caring for COVID-19 patients at the time of admission. Members of the care team were surveyed and interviewed regarding their experiences with this added support. During a period of peak hospital strain from COVID-19, team members consistently reported that daily PCP involvement led to improvement in communication with patients and families, greater provider awareness of psychosocial stressors, and decreased physician burnout. Integration of a PCP into a clinical care team during the COVID-19 pandemic was perceived as a valuable asset to patients, families, and clinicians.

BACKGROUND: Levels of stress and burnout continue to rise amongst healthcare workers. In addition to systemic and institution-level changes to healthcare practice environments, well-being interventions, resources, and support to assist healthcare providers are necessary. Meditation practices like Heart Rhythm Meditation (HRM) may provide benefits to healthcare workers, but healthcare worker experiences with HRM are not well understood. OBJECTIVE: To explore healthcare worker experiences with HRM using a journey mapping approach. METHODS: An exploratory cross-sectional online survey was administered between May and July of 2020 to a purposeful sample of 25 healthcare workers currently practicing HRM. Surveys consisted of 5 open-ended and 36 multiple-choice items mapped to five journey mapping domains: Discover, Search, Assess, Decide, Assist. Descriptive statistics for survey items were generated in addition to a visual representation of a Persona and associated journey map for HRM. Content analysis was performed on open-ended responses using a general inductive approach to code responses and identify representative quotes. RESULTS: Twenty surveys were completed for a response rate of 80%. The majority of respondents identified as women (n = 14). From the journey mapping output, the overall emotional experience score was an 8.2/10, suggesting respondents had positive experiences with HRM. Open-ended comments suggest that HRM provides important benefits to the personal and professional lives of healthcare workers. A small number of participants reported challenges like feeling difficult emotions during HRM practice. CONCLUSION: Mapping the healthcare worker journey with HRM identified generally positive experiences with personal and professional benefits. While experiences were largely positive, HRM elicited difficult emotions from some individuals, suggesting that appropriate resources and support are required when considering HRM and other meditation forms.

[This is an excerpt.] Cardiothoracic surgery is a demanding field that requires technical skills, mental agility, and emotional resilience. Performing operations on vital organs in high-stress situations carries significant risks for patients and providers alike. Despite the rewards of saving lives and improving patients’ quality of life, cardiothoracic surgeons are vulnerable to burning out, wherein they feel emotionally, mentally, and physically exhausted. Burnout has far-reaching consequences for individual surgeons, their teams, and the broader healthcare system, yet it remains an under-recognized and under-addressed challenge in the field. Therefore, we examined the prevalence and impact of cardiothoracic surgeon burnout, by exploring potential contributing factors and discussing strategies for prevention and intervention. [To read more, click View Resource.]

PURPOSE: To evaluate lesbian, gay, bisexual, transgender, questioning, and other sexual/gender minority (LGBTQ+) orientation as a burnout risk factor among an international ophthalmologist cohort. METHODS: An anonymous, cross-sectional electronic survey was distributed via an Internet platform to characterize the relationship among demographic factors, including LGBTQ+ orientation, and burnout as measured by the Copenhagen Burnout Inventory (CBI). Univariable data analysis (linear) by sexual orientation was performed and variables with an association with a P value of <0.15 in univariable analysis were included in the multiple linear regression modeling. RESULTS: A total of 403 ophthalmologists participated in the survey. The majority self-identified as "White" (69.2%), were from North America (72.0% United States, 18.6% Canada) and were evenly distributed between age of 30 and 65 years. Overall, 13.2% of participants identified as LGBTQ+ and 98.2% as cisgender. Approximately 12% had witnessed or experienced LGBTQ+-related workplace discrimination or harassment. The personal and work-related burnout scores and confidence limits of persons identified as LGBTQ+ were higher and nonoverlapping compared with those reported as non-LGBTQ+. Multivariable analysis identified significant risk factors for higher personal and work-related burnout scores: LGBTQ+ (11.8 and 11.1, P = .0005 and .0023), female gender (5.36 and 4.83, P = .0153 and .0434), older age (19.1 and 19.2, P = .0173 and .0273). and caretaker stress (6.42 and 5.97, P = .0085 and .0239). CONCLUSIONS: LGBTQ+ orientation is a burnout risk factor among ophthalmologists, and LGBTQ+ workplace discrimination may be a contributing factor. Support from ophthalmology organizations to address LGBTQ+-, gender-, and age-related workplace discrimination may decrease burnout. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

This cross-sectional study examines the association between labor unions and health care staff turnover in the US using data from 2021.

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This resource is found in our Actionable Strategies for Government: Empowering Workers & Strengthening Leadership and Governance (Strengthening Protections to Speak Up)

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OBJECTIVES: Few studies have elucidated the impact of work-related trauma on labor and delivery clinician or considered whether it may be a cause of burnout. This study aims to elicit labor and delivery clinician perspectives on the impact of exposure to traumatic births on their professional quality of life. METHODS: Labor and delivery clinicians (physicians, midwives, nurse practitioners, and nurses; n = 165) were recruited to complete an online questionnaire on experiences with traumatic births. The questionnaire contained measures from the Maslach Burnout Inventory and the professional quality of life scale version 5. Some participants completed an optional free-text prompt to recommend ways to support clinicians after traumatic births (n = 115). others opted into a semi-structured phone interview (n = 8). Qualitative data was analyzed using a modified grounded theory approach. RESULTS: Self-reported adequate institutional support for clinicians after a traumatic birth was positively correlated with compassion satisfaction (r = 0.21, p < 0.01) and negatively correlated with secondary traumatic stress (r = - 0.27, p < 0.01), and burnout (r = - 0.26, p < 0.01). Qualitative themes included lack of system-wide and leadership support, lack of access to mental-health resources, and suboptimal workplace culture as contributors toward secondary traumatic stress and burnout. Participants recommended proactive leadership, consistent debriefing protocols, trauma education, and improved access to counseling. CONCLUSIONS FOR PRACTICE: Multi-level barriers prevented labor and delivery clinicians from accessing needed mental health support after exposure to traumatic births. Proactive investment in healthcare system supports for clinicians may improve clinician professional quality of life.

[This is an excerpt.] Before the COVID-19 pandemic and going as far back as the Harvard Medical Practice Study,1 it has been common to hear leaders lament the seemingly tedious discussions about health care worker (HCW) burnout and work-life integration. Fast forward post pandemic and it is hard to imagine a leader who is not routinely discussing workforce well-being. How are leaders supposed to navigate these new well-being responsibilities? In this issue of Mayo Clinic Proceedings, Hurtado and colleagues2 offer some empirical insights to inform well-being leadership efforts, saying that the burden of emotional exhaustion management “often falls back on clinic leaders who desperately need urgent guidance to implement swift, low-effort, practical and meaningful strategies to manage an afflicted workforce.” We agree. This has been our experience at Duke Health and across hundreds of US hospitals in which we have surveyed safety culture and workforce well-being since the start of the global health crisis. What leaders want and need right now are specific actions to help recover from pandemic exhaustion, to rebuild trust—and by the way, whatever that entails, it needs to be quick and fit into increasingly shrinking budgets. Furthermore, this is against a backdrop of growing numbers of frustrated HCWs adopting the refrain “Just fix the system!” as their exhaustion worsens. Meanwhile, frustrated health care leaders manage the combination of financial constraints and workforce challenges as a gordian knot, consuming all energy while too complex to be untied. Currently, there are few system fixes that are broadly applicable across all of health care, but Hurtado et al are shining a light on one with broad potential. [To read more, click View Resource.]

Gender parity has been reached in graduation rates from medical school, yet women in medicine continue to face obstacles in promotion, compensation and opportunities, leading to leadership inequity, higher burnout and lower engagement. These complex issues with gender are just one aspect of the wide challenges related to diversity, equity and inclusion among medical professionals. While there are no “one size fits all” approaches, psychologists are well positioned to lead efforts related to promoting leadership equity, reducing burnout and raising engagement because of their training in communication skills, programmatic development and empathetic listening. This paper details several evidence-based efforts in which psychologists can lead in these ongoing issues for women in medicine.

Mental fatigue and burnout are concerns for healthcare organizations, but their effects on leaders have not been thoroughly studied. Infectious diseases teams and leaders are at risk for mental fatigue and burnout due to the increased demands from the coronavirus disease 2019 (COVID-19) pandemic, additive effects of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) (omicron) and δ (delta) variant surges, and unique pre-existing pressures. No single intervention can reduce stress and burnout in healthcare workers. Work-hour limitations may have the biggest impact in physician burnout mitigation. Institutional and individual programs focused on mindfulness may improve well-being in the workplace. Leading during times of stress requires a multimodal approach and an understanding of goals and priorities. Greater awareness of burnout and fatigue across the healthcare spectrum and continued research are required to advance healthcare worker well-being.

The COVID-19 pandemic has had an unprecedented impact on the US health care system which was already experiencing higher levels of personal burnout among health care workers than the average US worker. Well-being efforts to support the workforce have become a critical countermeasure during the pandemic. This work was presented at the Thomas Jefferson University, College of Population Health Seminar Series: Clinical Lessons from the Northeast Surge, COVID-19: Spread the Science, not the Virus, held August 18, 2020. The entire series was held virtually from July 21 to September 29, 2020. The authors describe issues impacting health care workers during this early period of the pandemic with two examples of concrete strategies to approach well-being at the organizational level and lessons learned.

This resource is found in our Actionable Strategies for Health Organizations: Establishing Commitment & Shared Governance (Organizational Infrastructure for Well-Being).