Approaches to Improving the Well-Being of Clinicians

Educational Objectives

The goal of this program is to improve the well-being of anesthesiologists. After hearing and assimilating this program, the clinician will be better able to:

1. Address causes of burnout among health care providers in anesthesiology.

Summary

Drivers of burnout: include workload and job demands, control and flexibility, social support and community at work, organizational culture and values, and efficiency and resources; burnout typically occurs because of a perceived lack of support at work; the COVID-19 pandemic has had measurable effects on finances, home responsibilities, retirement planning, which affect women more than men

Effects of burnout: medical errors — anesthesiology residents who are burnt out are less likely to check, eg, medicine vials, anesthesia machines, chest x-rays; malpractice — burnout is linked to higher probability of lawsuits; health care teams and units that have higher rates of burnout have higher rates of health care-associated infections and intensive care unit mortality

Approach to well-being: 3 levels of commitment are individual, organizational, and societal commitment

Maslach Burnout Inventory: a survey focusing on 6 areas of work life; workload — consider sustainable recovery; control — consider control in work or work life; reward — has little correlation with money; consider the feeling of being appreciated at work; community — consider the type of community one has in the workplace; fairness — considers diversity, equity, inclusion, and respect; value — consider meaningfulness one finds in their work

Creating a community: can be achieved with intentional team meetings; may begin by sharing details that team members usually do not know about each other to “break the ice” and promote warmth (improves the quality of future interactions at work)

Challenges of anesthesiologists: they observe human suffering very closely and are also affected by it; 84% have a perioperative catastrophe during their career

Management: an individualized approach to helping clinicians cope with a catastrophic event is preferred; not everyone recovers with time away from work alone; systems should be in place to manage situations; having peer support teams is currently the most effective intervention; time off during sickness needs to be normalized

Social recognition: employees who are recognized at work by their boss and peers are happier and are better employees

Empowering to be in charge: there is an increasing divide between administration and clinicians; the Pebble Project created by the speaker aims to enhance the health care provider experience by maximizing personal and professional conditions that maximize well-being; Pebble represents issues that need to be addressed, eg, workload control, scheduling predictability, lack of community building, administrative support, upgrading information technology, hiring process changes, and ability to escalate issues; system support and local well-being efforts are essential

Readings

Aron R, Pawlowski J, Shukry M, et al. The impact of COVID-19 on the status of the anesthesiologists' well-being. Adv Anesth. 2021 Dec; 39:149-167. doi: 10.1016/j.aan.2021.07.009; Brainard AJ, Hoy LM. Total well-being in anesthesiology: looking beyond COVID-19. Anesthesiol Clin. 2022 Jun; 40(2):xv-xvi. doi: 10.1016/j.anclin.2022.01.015; Chong MYF, Lin SHX, Lim WY, et al. Burnout in anaesthesiology residents: A systematic review of its prevalence and stressors. Eur J Anaesthesiol. 2022;39(4):368-377. doi:10.1097/EJA.0000000000001585; Gray RM, Evans FM. Well-being of the global anesthesiologist. Paediatr Anaesth. 2021 Jan; 31(1):13-15. doi: 10.1111/pan.14093; Malinzak EB, Byerly SI. Burnout from gender inequity in a pandemic. Anesthesiol Clin. 2022 Jun; 40(2):225-234. doi: 10.1016/j.anclin.2021.12.001.

Disclosures

For this program, members of the faculty and planning committee reported nothing relevant to disclose.

Acknowledgements

Dr. Margolis was recorded at the 60th Clinical Conference in Pediatric Anesthesiology, held on February 11-13, 2022, and presented by Pediatric Anesthesiology Foundation, Children's Hospital Los Angeles. For information on future CME activities from this presenter, please visit https://pediatric-anesthesiology-foundation.com/. Audio Digest thanks the speakers and presenters for their cooperation in the production of this program.

CME/CE INFO

Accreditation:

The Audio- Digest Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Audio- Digest Foundation designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Audio Digest Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's (ANCC's) Commission on Accreditation. Audio Digest Foundation designates this activity for 0.75 CE contact hours.

Lecture ID:

AN644303

Expiration:

This CME course qualifies for AMA PRA Category 1 Credits™ for 3 years from the date of publication.

Instructions:

To earn CME/CE credit for this course, you must complete all the following components in the order recommended: (1) Review introductory course content, including Educational Objectives and Faculty/Planner Disclosures; (2) Listen to the audio program and review accompanying learning materials; (3) Complete posttest (only after completing Step 2) and earn a passing score of at least 80%. Taking the course Pretest and completing the Evaluation Survey are strongly recommended (but not mandatory) components of completing this CME/CE course.

Estimated time to complete this CME/CE course:

Approximately 2x the length of the recorded lecture to account for time spent studying accompanying learning materials and completing tests.