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The United States is facing a worsening epidemic of physician burnout with unprecedented numbers of them leaving the workforce and practice of clinical medicine across all career stages. The prevalence of physician burnout has accelerated through COVID-19, resulting in an anticipated serious national shortage of physicians within the current decade amidst an increased proportion of aging and unhealthy population. The critical shortage of physicians coupled with an unhealthy physician workforce results in longer wait times for access, continued increased healthcare costs, decreased quality of care, and worsening patient experience. Despite increasing media coverage, published data, and identification of system-based factors that erode physician wellbeing, no standardized systematic solution has been implemented across hospitals, health systems, or a variety of employment models or practice settings for any or all doctors regardless of whether they are primary care, medical, or surgical subspecialists. Effective solutions to mitigate physician burnout, protect current working physicians, and keep them from leaving medicine require a SHIFT and a more individualized approach. Many proposed academic models address system-based factors, but such solutions depend greatly on those who employ doctors. Executive leadership in charge of healthcare systems are often challenged by physician burnout and their desired autonomy, against the need for standardization of care delivery to improve quality and decrease cost. Physician productivity measures continue to be based on data samples of physician compensation surveys supplied by companies like Sullivan Cotter or Medical Group Management Association (MGMA). Such benchmarks are commonly used but data may not reflect specific realities for any organizations nor the rapid changes in the landscape of US healthcare amidst mergers, acquisitions, consolidation, and shifts in employment models from insurance and online retail giants and private equity. This book uses a "checklist" approach to empower any medical student, resident, fellow, or practicing physician to create and experience psychological, personal, and professional safety and wellbeing. Not only can individual physicians choose and use these checklists themselves, but those who live with, love, and cherish one or more physicians in their families and/or lives can use this book to understand physician realities and their risks.
Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace tells a story of hope for professional fulfillment and well-being through organizational interventions that nurture positivity and push negativity aside. The authors provide a road map based on their experience in quality, department operations, leadership and organization development, management, safe havens, and care teams. They draw from their roles as president, chief wellness officer, chief quality officer, associate dean, chair, principal investigator, senior fellow, and board director.
This book explores the important topic of mental health and related problems among physicians, including trainees. The all-too-common human response of “suffering in silence” and refusing to seek help for professional and personal issues has ramifications for physicians who work in safety-sensitive positions, where clear-headed judgment and proper action can save lives. Problems covered include burnout, disruptive and unprofessional behaviors, impaired performance, traumatic stress, addiction, depression and other mood disorders, and suicide. The authors of this work include psychologists, psychiatrists, and other physicians who diagnose and treat a range of patients with stress-related syndromes. Among their patients are physicians who benefit greatly from education, support, coaching, and treatment. The book's content is organized into three parts with interconnecting themes. Part I focuses on symptoms and how physicians’ problems manifest at the workplace. Part II discusses the disorders underlying the manifesting symptoms. Part III focuses on interventions at both the individual and organizational levels. The major themes investigated throughout the book are developmental aspects; mental health and wellbeing as a continuum; and the multifactorial contributions of individual, interpersonal, organizational, and cultural elements to physician health. This book is intended for anyone who works with, provides support to, or professionally treats distressed physicians. It is also intended for healthcare leaders and organizations that are motivated to improve the experience of providing care and to change the culture of silence, such that seeking help and counsel become normal activities while minimizing stigma. By writing this book, the authors aim to outline effective pathways to well-being and a healthy work-life balance among physicians, so that they may provide optimal and safe care to their patients.
In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Medicine is a complex social institution which includes biomedical research, clinical practice, and the administration and organization of health care delivery. As such, it is amenable to analysis from a number of disciplines and directions. The present volume is composed of revised papers on the theme of "Responsibility in Health Care" presented at the Eleventh Trans Disciplinary Symposium on Philosophy and Medicine, which was held in Springfield, illinois on March 16-18, 1981. The collective focus of these essays is the clinical practice of medicine and the themes and issues related to questions of responsibility in that setting. Responsibility has three related dimensions which make it a suitable theme for an inquiry into clinical medicine: (a) an external dimension in legal and political analysis in which the State imposes penalties on individuals and groups and in which officials and governments are held accountable for policies; (b) an internal dimension in moral and ethical analysis in which individuals take into account the consequences of their actions and the criteria which bear upon their choices; and (c) a comprehensive dimension in social and cultural analysis in which values are ordered in the structure of a civilization ([8], p. 5). The title "Responsibility in Health Care" thus signifies a broad inquiry not only into the ethics of individual character and actions, but the moral foundations of the cultural, legal, political, and social context of health care generally.