Department of Family Medicine, Aurora Health Care; Aurora UW Medical Group; Department of Academic Affairs, Aurora Health Care

Presentation Notes

Poster presented at: Aurora Scientific Day; May 22, 2019; Milwaukee, WI.


Background: Well-being is a critical issue for health care, with burnout rates measured at up to 63% among family physicians. A recent meta-analysis of burnout and patient experience studies found a strong association between resident and physician wellness and quality of patient care. Nationally, indirect patient care responsibilities (visit notes, inboxes, phone calls) has been identified as a significant contributing factor for burnout. Primary care physicians who spend, on average, 6 hours/week on electronic health record work outside normal clinical time are 3 times more likely to report burnout. Our family medicine residents identified lack of time to manage patientrelated “in-boxes” as a barrier to their well-being.

Purpose: To determine if allocating one-half day/week to complete indirect patient care tasks reduced residents’ perceived administrative tasks burden and improved the patient’s experience.

Methods: Once clinical schedules were established, residency program leaders (faculty, clinic, chief residents) allowed residents on noncall rotation blocks to notify their preceptor if they wanted to take a half-day to perform administrative tasks. Ongoing and repeated communication using multiple forums and formats was provided to clarify the purpose and process for using this allocated time. The effectiveness of this intervention was evaluated using two outcomes (CG-CAHPS, Mayo Well-Being Index) and two process surveys (end-of-rotation, resident wellness) as pre/post metrics.

Results: On process survey results, the percentage of residents reporting that “things are piling up so high I don’t feel I can overcome them” decreased by 16% from >1 times/week to 1–2/ month. Further analysis revealed that as the number of half-days taken increased (from 4.0 to 4.5 half-days/rotation), residents felt more under control (1.4 to 1.7, with 1=strongly agree to 5=strongly disagree). Outcome measures demonstrated a positive pre/post change: Mayo Well-Being Index scores showed 1.2 positive change (on 6-point scale); CG-CAHPS percentiles in our two family medicine residency clinics increased (between-visit communication by 4 and 5 points, respectively, and test-results communication by 5 and 7 points, respectively).

Conclusion: Our results demonstrate that protected time for administrative tasks improves residents’ sense of control and wellbeing. Patient quality care scores also improved, highlighting the strong association between physician wellness and patient’s experience of care.

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