scholarly journals Doctor, how can we help you? Qualitative interview study to identify key interventions to target burnout in hospital doctors

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030209 ◽  
Author(s):  
Gillian Walsh ◽  
Blánaid Hayes ◽  
Yseult Freeney ◽  
Siobhain McArdle
Keyword(s):  
Work Stress ◽  
Key Management ◽  
Working Environment ◽  
Management Skills ◽  
Line Managers ◽  
Staffing Levels ◽  
Qualitative Interview Study ◽  
Semistructured Interviews ◽  
Education Interventions ◽  
Hospital Doctors

ObjectiveTo identify priority interventions for the prevention and reduction of work stress and burnout in hospital doctors through analysis of (1) doctors’ experiences of work stress and burnout and (2) their preferences with respect to interventions.DesignQualitative design using semistructured interviews analysed with deductive thematic analysis.SettingHospitals in Ireland.Participants32 hospital doctors (16 practising consultants and 16 doctors in training) from a range of specialties, career stages, hospital types and locations.ResultsPractical, system-focused interventions were found to be most needed. Challenges with basic entitlements, that is, accessing statutory leave, knowing in advance when leave can be taken and being adequately covered when on leave were identified as requiring urgent attention. Other priority interventions identified were the integration of psychological support in the everyday working environment, time and training for clinical line managers to perform key management activities such as debriefing and education interventions which highlight work stress risks and care pathways, teach self-care and train doctors in how to support one another.ConclusionsHospital doctors are feeling the effects of greater demand and fewer resources. What they most urgently need is adequate staffing levels, access to statutory leave and adequate cover when on leave. Doctors do not receive the support they need from their clinical line managers, who lack the skills and time to excel as people managers. Organisations should focus on developing clinical management skills across the system. The culture of medicine needs to change from stigmatisation and competitiveness to compassion and collaboration. Organisations, medical schools and professional bodies can steer this change through education.

scholarly journals Work Stress in NHS Employees: A Mixed-Methods Study

2020 ◽  
Vol 17 (18) ◽  
pp. 6464
Author(s):  
Jermaine M. Ravalier ◽  
Andrew McVicar ◽  
Charlotte Boichat
Keyword(s):  
Job Satisfaction ◽  
Mixed Methods ◽  
Sickness Absence ◽  
Work Stress ◽  
Working Conditions ◽  
Workplace Stress ◽  
Mental Wellbeing ◽  
Cross Sectional ◽  
Semistructured Interviews ◽  
Staff Wellbeing

The United Kingdom’s National Health Service (NHS) has a higher-than-average level of stress-related sickness absence of all job sectors in the country. It is important that this is addressed as work stress is damaging to employees and the organisation, and subsequently impacts patient care. The aim of this study was to gain an in-depth understanding of working conditions and wellbeing in NHS employees from three employing NHS Trusts through a mixed-methods investigation. First, a cross-sectional organisational survey was completed by 1644 respondents. Questions examined working conditions, stress, psychological wellbeing, job satisfaction, and presenteeism. This was followed by 33 individual semistructured interviews with NHS staff from a variety of clinical and nonclinical roles. Quantitative findings revealed that working conditions were generally positive, although most staff groups had high levels of workload. Regression outcomes demonstrated that a number of working conditions influenced mental wellbeing and stress. Three themes were generated from thematic analysis of the interview data: wellbeing at work, relationships, and communication. These highlight areas which may be contributing to workplace stress. Suggestions are made for practical changes which could improve areas of difficulty. Such changes could improve staff wellbeing and job satisfaction and reduce sickness absence.

Kulicke and Soffa Industries, Inc.: Designing a Supply Chain Network

2017 ◽  
pp. 1-14
Author(s):  
Gerry Yemen ◽  
Gal Raz ◽  
Martin N. Davidson
Keyword(s):  
Supply Chain ◽  
Key Management ◽  
Executive Education ◽  
Supply Chain Network Design ◽  
Supply Chain Network ◽  
Management Skills ◽  
Education Programs ◽  
Expansion Strategy ◽  
Alternative Sites ◽  
Global Company

Supply chain network design choices and the challenges in implementing and understanding how alternatives influence firm performance are key management skills that can be applied to the case of a global company, Kulicke and Soffa Industries, Inc. (K&S), and its expansion strategy. Suitable for the MBA, EMBA, GMBA, and executive education programs, the case explores the decision to expand the company's tool bonding capacity in order to manage its growth. The question becomes whether to grow current operations in Yokneam Israel or seek alternative sites. And if it was decided to seek a location outside of Israel, where exactly should the company go?

scholarly journals Changes in work stress among doctors in Norway from 2010 to 2019: a study based on repeated surveys

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037474
Author(s):  
Judith Rosta ◽  
Fredrik Bååthe ◽  
Olaf G Aasland ◽  
Karin Isaksson Rø
Keyword(s):  
Work Stress ◽  
Private Practice ◽  
Mixed Models ◽  
Short Form ◽  
Gender And Age ◽  
Effort Reward Imbalance ◽  
Marginal Means ◽  
Reward Imbalance ◽  
Hospital Doctors ◽  
Questionnaire Surveys

ObjectivesTo explore and discuss the changes in the levels of work stress for Norwegian doctors in different job positions (hospital doctors, general practitioners (GPs), private practice specialists, doctors in academia) from 2010 to 2019.DesignRepeated questionnaire surveys in 2010, 2016 and 2019, where samples were partly overlapping.SettingNorway.ParticipantsA representative sample of 1500–2200 doctors in different job positions. Response rates were 66.7% (1014/1520) in 2010, 73.1% (1604/2195) in 2016 and 72.5% (1511/2084) in 2019.Main outcome measureValidated 9-item short form of the ‘Effort–Reward Imbalance’ questionnaire. A risky level of work stress was defined as an effort/reward ratio above 1.0.AnalysesLinear mixed models with estimated marginal means of job positions controlled for gender and age. Proportions with 95% CIs.ResultsFrom 2010 to 2016 and further to 2019, GPs reported a significant increase in levels on the effort scale (ES: 2.96, 3.25, 3.51) and significant decrease in levels on the reward scale (RS: 4.27, 4.05, 3.67). No significant changes were reported by hospital doctors (ES: 3.13, 3.10, 3.14; RS: 4.09, 3.98, 4.04), private practice specialists (ES: 2.58, 2.61, 2.59; RS: 4.32, 4.32, 4.30) and doctors in academia (ES: 2.63, 2.51, 2.52; RS: 4.09, 4.11, 4.14). The proportion of doctors with risky levels of work stress increased significantly for GPs (10.3%, 27.7%, 40.1%), but did not significantly change for hospital doctors (23.0%, 27.3%, 26.9%), private practice specialists (8.2%, 12.7%, 9.4%) and doctors in academia (11.9%, 19.0%, 16.4%).ConclusionDuring a 9-year period, the proportion of risky levels of work stress increased significantly for GPs but did not significantly change for other job positions. This may be partly due to changes in expectations of younger GPs and several healthcare reforms and regulations.

Emergency medicine: what keeps me, what might lose me? A narrative study of consultant views in Wales

2017 ◽  
Vol 34 (7) ◽  
pp. 436-440 ◽  
Author(s):  
Ffion James ◽  
Frances Gerrard
Keyword(s):  
Role Models ◽  
High Volume ◽  
Working Environment ◽  
Narrative Approach ◽  
Junior Doctors ◽  
Early Exposure ◽  
Narrative Study ◽  
Flexible Working ◽  
Semistructured Interviews

EDs are currently under intense pressure due to increased patient demand. There are major issues with retention of senior personnel, making the specialty a less attractive choice for junior doctors. This study aims to explore what attracted EM consultants to their career and keeps them there. It is hoped this can inform recruitment strategies to increase the popularity of EM to medical students and junior doctors, many of whom have very limited EM exposure.MethodsSemistructured interviews were conducted with 10 consultants from Welsh EDs using a narrative approach.ResultsThree main themes emerged that influenced the career choice of the consultants interviewed: (1) early exposure to positive EM role models; (2) non-hierarchical team structure; (3) suitability of EM for flexible working. The main reason for consultants leaving was the pressure of work impacting on patient care.ConclusionThe study findings suggest that EM consultants in post are positive about their careers despite the high volume of consultant attrition. This study reinforces the need for dedicated undergraduate EM placements to stimulate interest and encourage medical student EM aspirations. Consultants identified that improving the physical working environment, including organisation, would increase their effectiveness and the attractiveness of EM as a long-term career.

scholarly journals Occupational medicine - then and now: Where we could go from here

2014 ◽  
Vol 67 (5-6) ◽  
pp. 139-148 ◽  
Author(s):  
Karen Belkic ◽  
Olesja Nedic
Keyword(s):  
Work Stress ◽  
Occupational Medicine ◽  
Public Health Problem ◽  
Work Conditions ◽  
Theory And Practice ◽  
Working Environment ◽  
Major Public Health Problem ◽  
Research Perspective ◽  
Work Related ◽  
Starting Point

Occupational medicine has a long-standing history in the region of the former Yugoslavia with seminal contributions to the theory and practice of this discipline. This tradition should be expanded to incorporate psychosocial stressors. We review the sociological work stress models and empirical evidence gleaned thereby, and then the occupational stressor index, an additive burden model developed from a cognitive ergonomics perspective. In numerous studies, the occupational stressor index is significantly associated with risk behaviors: smoking, obesity and sedentariness and clinical outcomes: hypertension, ischemic heart disease, dyslipidemia and type 2 diabetes. The occupational stressor index characterizes the work conditions of physicians including surgeons and anesthesiologists; professional drivers and other groups at elevated risk for stress-related disorders. Much of these empirical data are from this region. Work-stress related health disorders are a major public health problem, with enormous human and economic costs. A more proactive role for physicians is needed vis-?-vis our working environment and that of patients. We physicians face a heavy job stressor burden strongly implicated with adverse health outcomes. The challenge is to identify effective strategies to lower the risk of work-stressor related illness. The critical gap is the lack of evidence-based guidelines. Intervention studies are needed in which job stressors are ameliorated as a therapeutic/preventive modality; the logical starting point is within our own profession. We also suggest how the relevant clinical competence could be enhanced. Alongside clinical enhancement should be the full restoration of physician empowerment to implement work-related recommendations. A participatory action research perspective by physicians for physicians and for our patients is needed.

scholarly journals Factors Affecting Definitions of and Approaches to Integrative Medicine: A Mixed Methods Study Examining China’s Integrative Medicine Development

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Weijun Zhang ◽  
Sonya E. Pritzker ◽  
Ka-Kit Hui
Keyword(s):  
Mixed Methods ◽  
Integrative Medicine ◽  
Mixed Methods Study ◽  
Working Environment ◽  
Snowball Sampling ◽  
Key Factors ◽  
Factors Affecting ◽  
Education Practice ◽  
Key Characteristics ◽  
Semistructured Interviews

Aim. This study identifies existing definitions and approaches among China’s integrative medicine (IM) experts and examines relationships with key characteristics distinguishing individual experts.Methods. Snowball sampling was used to select 73 IM experts for semistructured interviews. In this mixed methods study, we first identified definitions and approaches through analyzing core statements. Four key factors, including age, education, practice type, and working environment, were then chosen to evaluate the associations with the definitions.Results. Four unique definitions were identified, including IM as a “new medicine” (D1), as a combination of western medicine (WM) and Chinese medicine (CM) (D2), as a modernization of CM (D3), and as a westernization of CM (D4). D4 was mostly supported by those working in WM organizations, while D3 was more prominent from individuals working in CM organizations (P=0.00004). More than 64% clinicians had D2 while only 1 (5.9%) nonclinician had D2. Only 1 clinician (1.8%) had D4 while almost 30% nonclinicians had D4 (P=0.0001). Among nonclinicians working in WM organizations, 83.3% of them had D4 (P=0.001).Conclusion. Findings indicate that institutional structure and practice type are factors affecting IM approaches. These results carry implications for the ways in which western countries move forward with the definition and implementation of IM.

scholarly journals The Preferences of Patients With Cancer Regarding Apps to Help Meet Their Illness-Related Information Needs: Qualitative Interview Study

10.2196/14187 ◽  
2019 ◽  
Vol 7 (7) ◽  
pp. e14187 ◽  
Author(s):  
Rebecca Richards ◽  
Paul Kinnersley ◽  
Kate Brain ◽  
John Staffurth ◽  
Fiona Wood
Keyword(s):  
Information Exchange ◽  
Information Needs ◽  
Patients With Cancer ◽  
Related Information ◽  
App Development ◽  
South Wales ◽  
Qualitative Interview Study ◽  
Semistructured Interviews ◽  
Potential Benefits ◽  
Question Prompt List

Background The shift from inpatient to outpatient and community cancer care means that more patients with cancer need to manage their condition at home, without the direct supervision of their clinician. Subsequently, research has reported that many patients with cancer have unmet information needs during their illness. Mobile devices, such as mobile phones and tablet computers, provide an opportunity to deliver information to patients remotely. Before designing an app intervention to help patients with cancer to meet their information needs, in-depth qualitative research is required to gain an understanding of the views of the target users. Objective We aimed to develop an app intervention to help patients meet their illness-related information needs in noninpatient settings. This study explored the information needs of patients with cancer and their preferences for an app and desired app features. Specifically, the perceived acceptability of an app, desired app features, and the potential benefits and disadvantages of, and barriers to, an app were explored. Methods Qualitative, one-on-one semistructured interviews were conducted with patients with urological, colorectal, breast, or gynecological cancers (N=23) across two hospitals in South Wales. Interviews were audio-taped, transcribed, and analyzed using a thematic analysis. Results Findings indicated that barriers to information exchange and understanding in consultations, and identification of reliable information sources between consultations, appeared to contribute to patients’ unmet information needs. Consequently, app feature suggestions included a question prompt list, a glossary of cancer terms, a resources feature, and a contacts feature. Anticipated benefits of this type of app included a more informed patient, improved quality of life, decreased anxiety, and increased confidence to participate in their care. The anticipated barriers to app use are likely to be temporary or can be minimized with regard to these findings during app development and implementation. Conclusions This study highlights the desire of patients with cancer for an app intervention to help them meet their information needs during and between consultations with their clinicians. This study also highlights the anticipated acceptability and benefits of this type of intervention; however, further research is warranted.

scholarly journals The Management Skills of SALL Managers

2013 ◽  
pp. 236-252
Author(s):  
David Gardner ◽  
Lindsay Miller
Keyword(s):  
Hong Kong ◽  
Key Management ◽  
Management Skills ◽  
Skill Sets

This paper looks at the management skills of SALL managers. It is based on data collected using quantitative and qualitative instruments with six SALL managers in tertiary contexts in Hong Kong. With reference to the literature in the field of management, the paper reviews the data in terms of identifiable management skills. This provides a picture of the skills possessed by these managers and also identifies gaps in their skill-sets. The paper provides a checklist of skills relevant to SALL management which individual managers may find useful, and also discusses the 4 key management areas of leadership, scope, expectations and evaluation.

scholarly journals I need to be who I am: a qualitative interview study exploring the needs of people with dementia in Norway

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e035886
Author(s):  
Elisabeth Wiken Telenius ◽  
Siren Eriksen ◽  
Anne Marie Mork Rokstad
Keyword(s):  
Qualitative Content Analysis ◽  
User Involvement ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Community Services ◽  
Cross Sectional ◽  
People With Dementia ◽  
Qualitative Interview Study ◽  
Semistructured Interviews ◽  
The Moment

ObjectiveMany people with dementia receive community services. These services are often based on the needs of informal caregivers and professional caregivers’ assessment. User involvement and participation are main objectives in the Norwegian National Dementia Plan 2020. To enhance user involvement and individual tailoring of healthcare services, more information is required about the needs of people with dementia. The aim of this study was to explore the experienced needs of people with dementia in order to facilitate user involvement in provided services.MethodsAn explorative cross-sectional study design was used. We performed semistructured interviews with people with dementia who were recruited from all regions of Norway. The sample comprised 35 participants diagnosed with dementia. The interviews were audio-recorded and transcribed, and the data material was analysed using a qualitative content analysis.ResultsThree main categories emerged from the interviews: (1) to stay connected; (2) to be active and participate; and (3) to live for the moment. The overarching theme was: the need to be who I am.ConclusionsPeople with dementia participating in the study were heterogeneous regarding wants and requirements. Most of them expressed the need and wish to hold on to who they are. Close and robust relations with family and friends can give significant support to people with dementia. However, living with dementia might put considerable strain on relations. Services should provide support to enhance relationships, encourage existing networks to remain stable and facilitate participation in meaningful activities for people living with dementia.

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