Lauren A Peccoralo1,2,3, Carly A Kaplan2, Robert H Pietrzak4,5,6, Dennis S Charney7,8,9, Jonathan A Ripp1,2,3. 1. Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 2. Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 3. Office of Well-being and Resilience, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 4. US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA. 5. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA. 6. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA. 7. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 8. Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 9. Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abstract
OBJECTIVE: To identify specific thresholds of daily electronic health record (EHR) time after work and daily clerical time burden associated with burnout in clinical faculty. MATERIALS AND METHODS: We administered an institution-wide survey to faculty in all departments at Mount Sinai Health System from November 2018 to February 2019. The Maslach Burnout Inventory and Mayo Well-Being Index assessed burnout. Demographics, possible confounding variables, and time spent on EHR work/clerical burden were assessed. RESULTS: Of 4156 eligible faculty members, 1781(42.9%) participated in the survey. After adjustment for background factors, EHR frustration (odds ratio [OR]=1.64-1.66), spending >90 minutes on EHR-outside the workday by self-report (OR = 1.41-1.90) and >1 hour of self-reported clerical work/day (OR = 1.39) were associated with burnout. Reporting that one's practice unloads clerical burden (OR = 0.50-0.66) and higher resilience scores (OR = 0.77-0.84) were negatively associated with burnout.Spending >90 minutes/day on EHR-outside work (OR = 0.66-0.67) and >60 minutes/day on clerical work (OR = 0.54-0.58) was associated with decreased likelihood of satisfactory work-life integration (WLI) and professional satisfaction (PS). Greater meaning in work was associated with an increased. LIKELIHOOD: of achieving WLI (OR = 2.51) and PS (OR = 21.67). CONCLUSION: Results suggest there are thresholds of excessive time on the EHR-outside the workday (>90 minutes) and overall clerical tasks (>60 minutes), above which clinical faculty may be at increased risk for burnout, as well as reduced WLI and PS, independent of demographic characteristics and clinical work hours. These thresholds of EHR and clerical burden may inform interventions aimed at mitigating this burden to reduce physician burnout.
OBJECTIVE: To identify specific thresholds of daily electronic health record (EHR) time after work and daily clerical time burden associated with burnout in clinical faculty. MATERIALS AND METHODS: We administered an institution-wide survey to faculty in all departments at Mount Sinai Health System from November 2018 to February 2019. The Maslach Burnout Inventory and Mayo Well-Being Index assessed burnout. Demographics, possible confounding variables, and time spent on EHR work/clerical burden were assessed. RESULTS: Of 4156 eligible faculty members, 1781(42.9%) participated in the survey. After adjustment for background factors, EHR frustration (odds ratio [OR]=1.64-1.66), spending >90 minutes on EHR-outside the workday by self-report (OR = 1.41-1.90) and >1 hour of self-reported clerical work/day (OR = 1.39) were associated with burnout. Reporting that one's practice unloads clerical burden (OR = 0.50-0.66) and higher resilience scores (OR = 0.77-0.84) were negatively associated with burnout.Spending >90 minutes/day on EHR-outside work (OR = 0.66-0.67) and >60 minutes/day on clerical work (OR = 0.54-0.58) was associated with decreased likelihood of satisfactory work-life integration (WLI) and professional satisfaction (PS). Greater meaning in work was associated with an increased. LIKELIHOOD: of achieving WLI (OR = 2.51) and PS (OR = 21.67). CONCLUSION: Results suggest there are thresholds of excessive time on the EHR-outside the workday (>90 minutes) and overall clerical tasks (>60 minutes), above which clinical faculty may be at increased risk for burnout, as well as reduced WLI and PS, independent of demographic characteristics and clinical work hours. These thresholds of EHR and clerical burden may inform interventions aimed at mitigating this burden to reduce physician burnout.
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