Pulled in Too Many Directions: The Causes and Consequences of Work-Work Conflict

Previous research has documented the influence of overwork and inflexible hours on work-life conflict for working professionals. In this paper, we build on this literature and explore the novel theoretical concept of work-work conflict, a form of inter-role conflict analogous to work-life conflict. Drawing on 48 in-depth interviews with 42 physicians and survey data of 60 faculty at a prominent west-coast academic medical center, we find that work-work conflict is fueled by institutional structural characteristics. Institutional incentives, the extent of recognition for various work activities, and financial rewards are misaligned, causing physicians to experience competing demands across multiple organizational missions (research, teaching, clinical care, and administration/service). Other industries may face similar conditions leading to work-work conflict. We conclude that work-life interventions are necessary but not sufficient to increase employee satisfaction, and that mechanisms to alleviate work-work conflict must be incorporated in practical solutions to address burnout.

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Preparing Clinical Text for Use in Biomedical Research

Medical Informatics ◽

10.4018/978-1-60566-050-9.ch159 ◽

2011 ◽

pp. 2085-2095

Author(s):

John P. Pestian ◽

Lukasz Itert ◽

Charlotte Andersen

Keyword(s):

Language Processing ◽

Medical Center ◽

Clinical Care ◽

Academic Medical Center ◽

Clinical Text ◽

Delivery Of Care ◽

Radiology Reports ◽

Academic Medical ◽

Textual Data ◽

Regulatory Actions

Approximately 57 different types of clinical annotations construct a patient’s medical record. These annotations include radiology reports, discharge summaries, and surgical and nursing notes. Hospitals typically produce millions of text-based medical records over the course of a year. These records are essential for the delivery of care, but many are underutilized or not utilized at all for clinical research. The textual data found in these annotations is a rich source of insights into aspects of clinical care and the clinical delivery system. Recent regulatory actions, however, require that, in many cases, data not obtained through informed consent or data not related to the delivery of care must be made anonymous (as referred to by regulators as harmless), before they can be used. This article describes a practical approach with which Cincinnati Children’s Hospital Medical Center (CCHMC), a large pediatric academic medical center with more than 761,000 annual patient encounters, developed open source software for making pediatric clinical text harmless without losing its rich meaning. Development of the software dealt with many of the issues that often arise in natural language processing, such as data collection, disambiguation, and data scrubbing.

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3115 Barriers and Resources in Career Development in Academic Medicine as Reported by Junior Faculty

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.147 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 63-63

Author(s):

Julie Schweitzer ◽

Julie Rainwater ◽

Rebeca Giacinto ◽

Hendry Ton

Keyword(s):

Time Management ◽

Medical Center ◽

Academic Medical Center ◽

Junior Faculty ◽

Work Life ◽

Individual Development ◽

Work Life Balance ◽

Medical Setting ◽

Life Balance ◽

Academic Medical

OBJECTIVES/SPECIFIC AIMS: To identify the most frequently reported barriers/constraints and resources by junior faculty in achieving their goals at a large medical school in the Western United States. METHODS/STUDY POPULATION: We reviewed 222 individual development plans (IDPs) from 26 departments in an academic medical center for content regarding constraints and resources to achieve activities and barriers and/or resources to achieve new goals. The content and quality of the IDPs included was ascertained using quantitative data analysis as well a review of open-ended qualitative questions. In addition to analyzing the content, the quality and percent completion of data filled out for each field in the IDP was also assessed to help identify gaps with departments in successfully completing and submitting their IDPs. RESULTS/ANTICIPATED RESULTS: Junior faculty indicated the following barriers: time/time management (55%); work/life balance (32%); funding (8%) and other (5%). Junior faculty also indicated that they had resources to help them achieve their goals, including: mentors (60%); collaborators (26%); colleagues (6%); other (8%). DISCUSSION/SIGNIFICANCE OF IMPACT: The barriers in goal achievement (e.g., time/time management & work/life balance issues) at this academic medical setting suggest that further resources regarding time management and work - life balance need to be developed and disseminated in order to assist faculty in achieving their objectives. This project also reinforces the importance of having a robust mentor or mentoring team for junior faculty. Mentors and administrators should work collaboratively with junior faculty to identify resources to improve time management and work-life balance.

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Physicians' Attitudes Toward Complementary and Alternative Medicine and Their Knowledge of Specific Therapies: A Survey at an Academic Medical Center

Evidence-based Complementary and Alternative Medicine ◽

10.1093/ecam/nel036 ◽

2006 ◽

Vol 3 (4) ◽

pp. 495-501 ◽

Cited By ~ 75

Author(s):

Dietlind L. Wahner-Roedler ◽

Ann Vincent ◽

Peter L. Elkin ◽

Laura L. Loehrer ◽

Stephen S. Cha ◽

...

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Medical Center ◽

Clinical Care ◽

Academic Medical Center ◽

Educational Interventions ◽

Level Of Evidence ◽

Web Based ◽

Academic Medical ◽

Complementary And Alternative

The purpose of this study was to evaluate the attitudes of physicians at an academic medical center toward complementary and alternative medicine (CAM) therapies and the physicians' knowledge base regarding common CAM therapies. A link to a Web-based survey was e-mailed to 660 internists at Mayo Clinic in Rochester, MN, USA. Physicians were asked about their attitudes toward CAM in general and their knowledge regarding specific CAM therapies. The level of evidence a physician would require before incorporating such therapies into clinical care was also assessed. Of the 233 physicians responding to the survey, 76% had never referred a patient to a CAM practitioner. However, 44% stated that they would refer a patient if a CAM practitioner were available at their institution. Fifty-seven percent of physicians thought that incorporating CAM therapies would have a positive effect on patient satisfaction, and 48% believed that offering CAM would attract more patients. Most physicians agreed that some CAM therapies hold promise for the treatment of symptoms or diseases, but most of them were not comfortable in counseling their patients about most CAM treatments. Prospective, randomized controlled trials were considered the level of evidence required for most physicians to consider incorporating a CAM therapy into their practice. The results of this survey provide insight into the attitudes of physicians toward CAM at an academic medical center. This study highlights the need for educational interventions and the importance of providing physicians ready access to evidence-based information regarding CAM.

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Career Morph: Quantitizing Adversity in Academic Medicine

The Qualitative Report ◽

10.46743/2160-3715/2016.2645 ◽

2016 ◽

Author(s):

Carol Isaac ◽

Rebecca McSorley ◽

Alexandra Schultz

Keyword(s):

Academic Medicine ◽

Medical Center ◽

Academic Medical Center ◽

Work Life ◽

Work Life Balance ◽

Life Balance ◽

Men And Women ◽

Clinician Educator ◽

Academic Medical ◽

Balance Analysis

Many qualitative researchers reject textual conversion based on philosophical grounds although others believe it facilitates pattern recognition and meaning extraction. This article examined interview data from 52 physicians from a large academic medical center regarding work–life balance. Analysis ranked men and women in four career tracks: Clinician-Educator, Clinician-Researcher, Clinician-Practitioner, and residents. The purpose of this paper is to illustrate how a qualitatively driven (QUAL→quan) mixed method design illustrated differences between stratified groups. Although many initial codes were similar for men and women, their language was gendered and generational in context of work-life balance. Results indicated that women (and low-status men) expressed fewer strategies to successfully negotiate academic medicine. Quantitizing enhanced the interpretive description of adversity.

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Improving the Quality of Clinical Care of Children with Diabetic Ketoacidosis in General Emergency Departments Following a Collaborative Improvement Program with an Academic Medical Center

The Journal of Pediatrics ◽

10.1016/j.jpeds.2021.08.081 ◽

2021 ◽

Author(s):

Hani Alsaedi ◽

Riad Lutfi ◽

Samer Abu-Sultaneh ◽

Erin E. Montgomery ◽

Kellie J. Pearson ◽

...

Keyword(s):

Diabetic Ketoacidosis ◽

Emergency Departments ◽

Medical Center ◽

Clinical Care ◽

Academic Medical Center ◽

Improvement Program ◽

Academic Medical

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The role of mentors in addressing issues of work–life integration in an academic research environment

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.408 ◽

2019 ◽

Vol 3 (6) ◽

pp. 302-307 ◽

Cited By ~ 1

Author(s):

Dennis R. Durbin ◽

Stephanie C. House ◽

Emma A. Meagher ◽

Jenna Griebel Rogers

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Academic Research ◽

Work Life ◽

Professional Lives ◽

Training Curriculum ◽

Mentor Training ◽

Research Environment ◽

Academic Medical ◽

Life Issues

AbstractIntroduction:There is growing evidence for both the need to manage work–life conflict and the opportunity for mentors to advise their mentees on how to do this in an academic research environment.Methods:A multiphase approach was used to develop and implement an evidence-informed training module to help mentors guide their mentees in issues of work–life conflict. Analysis of existing data from a randomized controlled trial (RCT) of a mentor training curriculum (n = 283 mentor/mentee dyads) informed the development of a work–life mentoring module which was incorporated into an established research mentor training curriculum and evaluated by faculty at a single academic medical center.Results:Only 39% of mentors and 36% of mentees in the RCT indicated high satisfaction with the balance between their personal and professional lives. The majority (75%) of mentors and mentees were sharing personal information as part of the mentoring relationship which was significantly associated with mentees’ ratings of the balance between their personal and professional lives. The effectiveness of the work–life module was assessed by 60 faculty mentors participating in a mentor training program at an academic medical center from 2013 to 2017. Among the respondents to the post-training survey, 82.5% indicated they were very/somewhat comfortable addressing work–life issues with their mentees as a result of the training, with significant improvements (p = 0.001) in self-assessments of mentoring skill in this domain.Conclusions:Our findings indicate that a structured training approach can significantly improve mentors’ self-reported skills in addressing work–life issues with their mentees.

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Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a US Academic Medical Center

Diagnostics ◽

10.3390/diagnostics11071172 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1172

Author(s):

Anna M. Maw ◽

Megan A. Morris ◽

Juliana G. Barnard ◽

Juliana Wilson ◽

Russell E. Glasgow ◽

...

Keyword(s):

Medical Center ◽

Point Of Care ◽

Clinical Care ◽

Academic Medical Center ◽

Point Of Care Ultrasound ◽

High Fidelity ◽

Structured Interviews ◽

Academic Medical ◽

Multi Level ◽

Fidelity Implementation

There is growing interest from multiple specialties, including internal medicine, to incorporate diagnostic point of care ultrasound (POCUS) into standard clinical care. However, few internists currently use POCUS. The objective of this study was to understand the current determinants of POCUS adoption at both the health system and clinician level at a U.S. academic medical center from the perspective of multi-level stakeholders. We performed semi-structured interviews of multi-level stakeholders including hospitalists, subspecialists, and hospital leaders at an academic medical center in the U.S. Questions regarding the determinants of POCUS adoption were asked of study participants. Using the framework method, team-based analysis of interview transcripts were guided by the contextual domains of the Practical Robust Implementation and Sustainability Model (PRISM). Thirty-one stakeholders with diverse roles in POCUS adoption were interviewed. Analysis of interviews revealed three overarching themes that stakeholders considered important to adoption by clinicians and health systems: clinical impact, efficiency and cost. Subthemes included two that were deemed essential to high-fidelity implementation: the development of credentialing policies and robust quality assurance processes. These findings identify potential determinants of system and clinician level adoption that may be leveraged to achieve high-fidelity implementation of POCUS applications that result in improved patient outcomes.

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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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