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Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records

IMPORTANCE: Electronic health records (EHRs) are considered a potentially significant contributor to clinician burnout. OBJECTIVE: To describe the association of EHR usage, sex, and work culture with burnout for 3 types of clinicians at an academic medical institution. DESIGN, SETTING, AND PARTICIPA...

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Autores principales: McPeek-Hinz, Eugenia, Boazak, Mina, Sexton, J. Bryan, Adair, Kathryn C., West, Vivian, Goldstein, Benjamin A., Alphin, Robert S., Idris, Sherif, Hammond, W. Ed, Hwang, Shelley E., Bae, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058638/
https://www.ncbi.nlm.nih.gov/pubmed/33877310
http://dx.doi.org/10.1001/jamanetworkopen.2021.5686
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author McPeek-Hinz, Eugenia
Boazak, Mina
Sexton, J. Bryan
Adair, Kathryn C.
West, Vivian
Goldstein, Benjamin A.
Alphin, Robert S.
Idris, Sherif
Hammond, W. Ed
Hwang, Shelley E.
Bae, Jonathan
author_facet McPeek-Hinz, Eugenia
Boazak, Mina
Sexton, J. Bryan
Adair, Kathryn C.
West, Vivian
Goldstein, Benjamin A.
Alphin, Robert S.
Idris, Sherif
Hammond, W. Ed
Hwang, Shelley E.
Bae, Jonathan
author_sort McPeek-Hinz, Eugenia
collection PubMed
description IMPORTANCE: Electronic health records (EHRs) are considered a potentially significant contributor to clinician burnout. OBJECTIVE: To describe the association of EHR usage, sex, and work culture with burnout for 3 types of clinicians at an academic medical institution. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study of 1310 clinicians at a large tertiary care academic medical center analyzed EHR usage metrics for the month of April 2019 with results from a well-being survey from May 2019. Participants included attending physicians, advanced practice providers (APPs), and house staff from various specialties. Data were analyzed between March 2020 and February 2021. EXPOSURES: Clinician demographic characteristics, EHR metadata, and an institution-wide survey. MAIN OUTCOMES AND MEASURES: Study metrics included clinician demographic data, burnout score, well-being measures, and EHR usage metadata. RESULTS: Of the 1310 clinicians analyzed, 542 (41.4%) were men (mean [SD] age, 47.3 [11.6] years; 448 [82.7%] White clinicians, 52 [9.6%] Asian clinicians, and 21 [3.9%] Black clinicians) and 768 (58.6%) were women (mean [SD] age, 42.6 [10.3] years; 573 [74.6%] White clinicians, 105 [13.7%] Asian clinicians, and 50 [6.5%] Black clinicians). Women reported more burnout (survey score ≥50: women, 423 [52.0%] vs men, 258 [47.6%]; P = .008) overall. No significant differences in EHR usage were found by sex for multiple metrics of time in the EHR, metrics of volume of clinical encounters, or differences in products of clinical care. Multivariate analysis of burnout revealed that work culture domains were significantly associated with self-reported results for commitment (odds ratio [OR], 0.542; 95% CI, 0.427-0.688; P < .001) and work-life balance (OR, 0.643; 95% CI, 0.559-0.739; P < .001). Clinician sex significantly contributed to burnout, with women having a greater likelihood of burnout compared with men (OR, 1.33; 95% CI, 1.01-1.75; P = .04). An increased number of days spent using the EHR system was associated with less likelihood of burnout (OR, 0.966; 95% CI, 0.937-0.996; P = .03). Overall, EHR metrics accounted for 1.3% of model variance (P = .001) compared with work culture accounting for 17.6% of variance (P < .001). CONCLUSIONS AND RELEVANCE: In this cross-sectional study, sex-based differences in EHR usage and burnout were found in clinicians. These results also suggest that local work culture factors may contribute more to burnout than metrics of EHR usage.
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spelling pubmed-80586382021-05-06 Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records McPeek-Hinz, Eugenia Boazak, Mina Sexton, J. Bryan Adair, Kathryn C. West, Vivian Goldstein, Benjamin A. Alphin, Robert S. Idris, Sherif Hammond, W. Ed Hwang, Shelley E. Bae, Jonathan JAMA Netw Open Original Investigation IMPORTANCE: Electronic health records (EHRs) are considered a potentially significant contributor to clinician burnout. OBJECTIVE: To describe the association of EHR usage, sex, and work culture with burnout for 3 types of clinicians at an academic medical institution. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study of 1310 clinicians at a large tertiary care academic medical center analyzed EHR usage metrics for the month of April 2019 with results from a well-being survey from May 2019. Participants included attending physicians, advanced practice providers (APPs), and house staff from various specialties. Data were analyzed between March 2020 and February 2021. EXPOSURES: Clinician demographic characteristics, EHR metadata, and an institution-wide survey. MAIN OUTCOMES AND MEASURES: Study metrics included clinician demographic data, burnout score, well-being measures, and EHR usage metadata. RESULTS: Of the 1310 clinicians analyzed, 542 (41.4%) were men (mean [SD] age, 47.3 [11.6] years; 448 [82.7%] White clinicians, 52 [9.6%] Asian clinicians, and 21 [3.9%] Black clinicians) and 768 (58.6%) were women (mean [SD] age, 42.6 [10.3] years; 573 [74.6%] White clinicians, 105 [13.7%] Asian clinicians, and 50 [6.5%] Black clinicians). Women reported more burnout (survey score ≥50: women, 423 [52.0%] vs men, 258 [47.6%]; P = .008) overall. No significant differences in EHR usage were found by sex for multiple metrics of time in the EHR, metrics of volume of clinical encounters, or differences in products of clinical care. Multivariate analysis of burnout revealed that work culture domains were significantly associated with self-reported results for commitment (odds ratio [OR], 0.542; 95% CI, 0.427-0.688; P < .001) and work-life balance (OR, 0.643; 95% CI, 0.559-0.739; P < .001). Clinician sex significantly contributed to burnout, with women having a greater likelihood of burnout compared with men (OR, 1.33; 95% CI, 1.01-1.75; P = .04). An increased number of days spent using the EHR system was associated with less likelihood of burnout (OR, 0.966; 95% CI, 0.937-0.996; P = .03). Overall, EHR metrics accounted for 1.3% of model variance (P = .001) compared with work culture accounting for 17.6% of variance (P < .001). CONCLUSIONS AND RELEVANCE: In this cross-sectional study, sex-based differences in EHR usage and burnout were found in clinicians. These results also suggest that local work culture factors may contribute more to burnout than metrics of EHR usage. American Medical Association 2021-04-20 /pmc/articles/PMC8058638/ /pubmed/33877310 http://dx.doi.org/10.1001/jamanetworkopen.2021.5686 Text en Copyright 2021 McPeek-Hinz E et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
McPeek-Hinz, Eugenia
Boazak, Mina
Sexton, J. Bryan
Adair, Kathryn C.
West, Vivian
Goldstein, Benjamin A.
Alphin, Robert S.
Idris, Sherif
Hammond, W. Ed
Hwang, Shelley E.
Bae, Jonathan
Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records
title Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records
title_full Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records
title_fullStr Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records
title_full_unstemmed Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records
title_short Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records
title_sort clinician burnout associated with sex, clinician type, work culture, and use of electronic health records
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058638/
https://www.ncbi.nlm.nih.gov/pubmed/33877310
http://dx.doi.org/10.1001/jamanetworkopen.2021.5686
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