Factors Associated With Physician Empowerment and Well-being at an Academic Medical Center

Abstract Objective Disparities in adult patient portal adoption are well-documented; however, less is known about disparities in portal adoption in pediatrics. This study examines the prevalence and factors associated with patient portal activation and the use of specific portal features in general pediatrics. Materials and methods We analyzed electronic health record data from 2012 to 2020 in a large academic medical center that offers both parent and adolescent portals. We summarized portal activation and use of select portal features (messaging, records access and management, appointment management, visit/admissions summaries, and interactive feature use). We used logistic regression to model factors associated with patient portal activation among all patients along with feature use and frequent feature use among ever users (ie, ≥1 portal use). Results Among 52 713 unique patients, 39% had activated the patient portal, including 36% of patients aged 0–11, 41% of patients aged 12–17, and 62% of patients aged 18–21 years. Among activated accounts, ever use of specific features ranged from 28% for visit/admission summaries to 92% for records access and management. Adjusted analyses showed patients with activated accounts were more likely to be adolescents or young adults, white, female, privately insured, and less socioeconomically vulnerable. Individual feature use among ever users generally followed the same pattern. Conclusions Our findings demonstrate that important disparities persist in portal adoption in pediatric populations, highlighting the need for strategies to promote equitable access to patient portals.

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Impact of Changes in EHR Use during COVID-19 on Physician Trainee Mental Health

Applied Clinical Informatics ◽

10.1055/s-0041-1731000 ◽

2021 ◽

Vol 12 (03) ◽

pp. 507-517

Author(s):

Katherine J. Holzer ◽

Sunny S. Lou ◽

Charles W. Goss ◽

Jaime Strickland ◽

Bradley A. Evanoff ◽

...

Keyword(s):

Stress Disorder ◽

Medical Center ◽

Academic Medical Center ◽

Well Being ◽

Health Record ◽

Depression And Anxiety ◽

Web Based ◽

Academic Medical ◽

Multivariable Models ◽

Physician Trainee

Abstract Objectives This article investigates the association between changes in electronic health record (EHR) use during the coronavirus disease 2019 (COVID-19) pandemic on the rate of burnout, stress, posttraumatic stress disorder (PTSD), depression, and anxiety among physician trainees (residents and fellows). Methods A total of 222 (of 1,375, 16.2%) physician trainees from an academic medical center responded to a Web-based survey. We compared the physician trainees who reported that their EHR use increased versus those whose EHR use stayed the same or decreased on outcomes related to depression, anxiety, stress, PTSD, and burnout using univariable and multivariable models. We examined whether self-reported exposure to COVID-19 patients moderated these relationships. Results Physician trainees who reported increased use of EHR had higher burnout (adjusted mean, 1.48 [95% confidence interval [CI] 1.24, 1.71] vs. 1.05 [95% CI 0.93, 1.17]; p = 0.001) and were more likely to exhibit symptoms of PTSD (adjusted mean = 15.09 [95% CI 9.12, 21.05] vs. 9.36 [95% CI 7.38, 11.28]; p = 0.035). Physician trainees reporting increased EHR use outside of work were more likely to experience depression (adjusted mean, 8.37 [95% CI 5.68, 11.05] vs. 5.50 [95% CI 4.28, 6.72]; p = 0.035). Among physician trainees with increased EHR use, those exposed to COVID-19 patients had significantly higher burnout (2.04, p < 0.001) and depression scores (14.13, p = 0.003). Conclusion Increased EHR use was associated with higher burnout, depression, and PTSD outcomes among physician trainees. Although preliminary, these findings have implications for creating systemic changes to manage the wellness and well-being of trainees.

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Factors associated with posttraumatic growth among healthcare workers at an academic‐medical center: A correlational study

Perspectives In Psychiatric Care ◽

10.1111/ppc.12817 ◽

2021 ◽

Author(s):

Chizimuzo T. C. Okoli ◽

Sarret Seng

Keyword(s):

Posttraumatic Growth ◽

Healthcare Workers ◽

Medical Center ◽

Academic Medical Center ◽

Correlational Study ◽

Factors Associated ◽

Academic Medical

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Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center—A Web-Based Survey

PLoS ONE ◽

10.1371/journal.pone.0140768 ◽

2015 ◽

Vol 10 (10) ◽

pp. e0140768 ◽

Cited By ~ 18

Author(s):

Erica Rose Denhoff ◽

Carly E. Milliren ◽

Sarah D. de Ferranti ◽

Sarah K. Steltz ◽

Stavroula K. Osganian

Keyword(s):

Clinical Research ◽

Medical Center ◽

Academic Medical Center ◽

Web Based ◽

Research Recruitment ◽

Factors Associated ◽

Academic Medical

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To Address Burnout in Oncology, We Must Look to Teams: Reflections on an Organizational Science Approach

JCO Oncology Practice ◽

10.1200/jop.19.00631 ◽

2020 ◽

Vol 16 (4) ◽

pp. e377-e383

Author(s):

Chelsea A. LeNoble ◽

Riley Pegram ◽

Marissa L. Shuffler ◽

Tranaka Fuqua ◽

Donald W. Wiper

Keyword(s):

Cancer Care ◽

Medical Center ◽

Academic Medical Center ◽

Well Being ◽

Lessons Learned ◽

Care Providers ◽

Intervention Approach ◽

Academic Medical ◽

Oncology Providers ◽

Organizational Science

PURPOSE: Despite decades of effort, burnout among physicians remains elevated compared with that of other working populations, and it yields catastrophic consequences, including medical errors and physician suicide. Burnout leaves oncologists feeling like they are alone, but this is not the case—it affects everyone. To effectively address burnout, it is not enough to look only at oncologists; instead, we must include all those involved in the delivery of cancer care. With this aim, we present an overview of the organizational science strategies and initial evidence for the value of a comprehensive, team-focused approach to addressing oncology provider burnout. METHODS: We describe the development of a team-focused burnout intervention approach, implemented for oncology providers, which focuses on the importance of encouraging communication and psychological safety to reduce feelings of isolation and fragmentation. We discuss the initial findings from 1 such team-based initiative currently underway within an academic medical center, presenting data from 409 cancer care providers embedded in 30 oncology units participating in this intervention approach. RESULTS: Preliminary results demonstrate that units that integrated a team-focused intervention for burnout reported significantly higher levels of teamwork and lower levels of burnout. We also describe lessons learned and recommendations for implementing this type of intervention on the basis of best practices from organizational science. CONCLUSION: This approach can positively affect the delivery of cancer care, interprofessional relationships among oncology staff, and the well-being of both patients and providers. Treating physician burnout alone will treat 1 symptom of the overall issue of burnout in oncology. As burnout pulls oncology clinicians apart, our solution must be to bring them together.

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Evaluation of the head and neck cancer patient population and the incidence of hospitalization at an academic medical center

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155217735688 ◽

2017 ◽

Vol 25 (2) ◽

pp. 333-338 ◽

Cited By ~ 4

Author(s):

Lindsay A Hazelden ◽

Matthew J Newman ◽

Stephanie Shuey ◽

Julie M Waldfogel ◽

Victoria T Brown

Keyword(s):

Logistic Regression ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Medical Center ◽

Academic Medical Center ◽

Factors Associated ◽

Chemotherapy Agent ◽

Academic Medical ◽

The Impact

Purpose Patients with head and neck cancer are at risk for disease- and treatment-related toxicities that may be severe enough to require hospitalization. The risk factors associated with hospitalization in these patients are not well defined. Methods We conducted a single-center, retrospective observational study of patients with head and neck cancer receiving chemotherapy at an academic medical center infusion clinic in a one-year period. The primary objective was to characterize the head and neck cancer population at an academic medical center. Secondary objectives included describing the clinical and social factors associated with hospitalization. Results There were 109 patients with head and neck cancer included in the analysis. Of these patients, 38 (35%) were hospitalized. The factors that were significantly associated with hospitalization on univariable logistic regression were former alcohol abuse, being on a nonstandard of care chemotherapy regimen, and having a chemotherapy agent discontinued. On multivariable logistic regression, the factor that was significantly associated with hospitalization was having a chemotherapy agent discontinued. The most common reasons for hospitalization included shortness of breath/respiratory failure, fever/neutropenic fever, and infection. The most common new supportive care medications prescribed at discharge were stool softeners or laxatives and opioids. Conclusion This study identified several factors which may be useful to identify patients as high risk for hospitalization and the next steps will be to determine and study the role of the pharmacist in preventing hospitalization of these patients. Further studies are needed to assess the impact of adding a pharmacist to the head and neck cancer multidisciplinary team.

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Outpatient hematologist and oncologist perceptions of inpatient continuity visits at an urban academic medical center.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.8_suppl.99 ◽

2017 ◽

Vol 35 (8_suppl) ◽

pp. 99-99

Author(s):

Christopher Chen ◽

Sara DeGregorio ◽

Margaret Soriano ◽

Inga Tolin Lennes ◽

Ryan Thompson ◽

...

Keyword(s):

Online Survey ◽

Financial Incentive ◽

Massachusetts General Hospital ◽

Medical Center ◽

Clinical Care ◽

Academic Medical Center ◽

Well Being ◽

Incentive Payment ◽

Academic Medical ◽

Inpatient And Outpatient Care

99 Background: In 2012, in an effort to improve continuity between inpatient and outpatient care, Massachusetts General Hospital (MGH) began sending automated email notifications to outpatient physicians when patients with whom they have an established relationship are admitted to MGH. Physicians are allowed to bill internally for a “continuity visit” if they visit their patient during an inpatient stay. We sought to study MGH hematologist and oncologist perceptions of care continuity and the efficacy of this continuity visit program. Methods: In the summer of 2015, all MGH hematology and oncology attending physicians, regardless of whether they had previously billed for a continuity visit, were provided a small financial incentive to participate in an online survey. Ninety-one of 116 physicians responded to the survey (78%). Results: Of the respondents, 74% had previously billed for a continuity visit, although others may have performed continuity visits without formally billing for them. Ninety-six percent of respondents felt that continuity visits are either highly useful or moderately useful to their patients, namely because patients view continuity visits as an expression of interest in their well-being (90%) and/or as a welcome surprise (58%). Ninety-one percent of respondents felt that continuity visits are highly or moderately useful to the inpatient team, because they are able to informally share clinical insights that improve clinical care (71%) and/or answer questions or confirm the inpatient attending’s plan of care (79%). Furthermore, 72% of respondents felt that continuity visits improve their longitudinal relationship with their patients. Lastly, 84% of respondents expressed high or moderate satisfaction with making continuity visits. Conclusions: MGH hematologists and oncologists reported that visiting their hospitalized patients is useful to inpatient care teams and their patients. A small incentive payment may encourage such continuity visits. The next step is to evaluate whether continuity visits make a difference in clinical outcomes, such as patient experience, readmissions, and inpatient length-of-stay.

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