Impact of Workplace Climate on Burnout Among Critical Care Nurses in the Veterans Health Administration

2020 ◽  
Vol 29 (5) ◽  
pp. 380-389 ◽  
Author(s):  
Lakshmana Swamy ◽  
David Mohr ◽  
Amanda Blok ◽  
Ekaterina Anderson ◽  
Martin Charns ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care System ◽  
Critical Care Nurses ◽  
Common Method ◽  
Health Administration ◽  
Workplace Climate ◽  
Common Method Bias ◽  
Method Bias ◽  
Care System

Background Burnout is a maladaptive response to work-related stress that is associated with negative consequences for patients, clinicians, and the health care system. Critical care nurses are at especially high risk for burnout. Previous studies of burnout have used survey methods that simultaneously measure risk factors and outcomes of burnout, potentially introducing common method bias. Objectives To evaluate the frequency of burnout and individual and organizational characteristics associated with burnout among critical care nurses across a national integrated health care system using data from an annual survey and methods that avoid common method bias. Methods A 2017 survey of 2352 critical care nurses from 94 sites. Site-level workplace climate was assessed using 2016 survey data from 2191 critical care nurses. Results Overall, one-third of nurses reported burnout, which varied significantly across sites. In multilevel analysis, workplace climate was the strongest predictor of burnout (odds ratio [OR], 2.20; 95% CI, 1.50-3.22). Other significant variables were overall hospital quality (OR, 1.44; 95% CI, 1.05-1.99), urban location (OR, 1.93; 95% CI, 1.09-3.42), and nurse tenure (OR, 2.11; 95% CI, 1.44-3.10). In secondary multivariable analyses, workplace climate subthemes of perceptions of workload and staffing, supervisors and senior leadership, culture of teamwork, and patient experience were each significantly associated with burnout. Conclusions Drivers of burnout are varied, yet interventions frequently target only the individual. Results of this study suggest that in efforts to reduce burnout, emphasis should be placed on improving local workplace climate.

scholarly journals Engaging African American Veterans with Health Care Access Challenges in a Community Partnered Care Coordination Initiative: A Qualitative Needs Assessment

2018 ◽  
Vol 28 (Supp) ◽  
pp. 475-484
Author(s):  
Adriana Izquierdo ◽  
Michael Ong ◽  
Felica Jones ◽  
Loretta Jones ◽  
David Ganz ◽  
...  
Keyword(s):  
Health Care ◽  
African American ◽  
Los Angeles ◽  
Health Care System ◽  
Health Care Access ◽  
Veterans Health ◽  
Health Administration ◽  
Health Care Environment ◽  
Care Access ◽  
Care System

Background: Little has been written about engaging potentially eligible members of a health care system who are not accessing the care to which they are entitled. Know­ing more about the experiences of African American Veterans who regularly experi­ence health care access challenges may be an important step toward equitable, coordi­nated Veterans Health Administration (VHA) care. This article explores the experiences of African American Veterans who are at risk of experiencing poor care coordination.Design: We partnered with a community organization to recruit and engage Veterans in three exploratory engagement workshops between October 2015 and February 2016.Participants and Setting: Veterans living in South Los Angeles, CaliforniaMain Outcome Measures: Veterans were asked to describe their experiences with community care and the VHA, a division of the US Department of Veterans Affairs (VA). Field notes taken during the workshops were analyzed by community and academic partners using grounded theory methodol­ogy to identify emergent themes.Results: 12 Veterans and 3 family members of Veterans participated in one or more en­gagement workshops. Their trust in the VA was generally low. Positive themes included: Veterans have knowledge to share and want to help other Veterans; and connecting to VA services can result in positive experi­ences. Negative themes included: functional barriers to accessing VA health care services; insensitive VA health care environment; lack of trust in the VA health care system; and Veteran status as disadvantageous for accessing non-VA community services.Conclusions: Veterans living in underserved areas who have had difficulty accessing VA care have unique perspectives on VA services. Partnering with trusted local com­munity organizations to engage Veterans in their home communities is a promising strategy to inform efforts to improve care access and coordination for vulnerable Vet­erans.Ethn Dis. 2018;28(Suppl 2):475-484; doi:10.18865/ed.28.S2.475.

Utilization of Interactive Clinical Video Telemedicine by Rural and Urban Veterans in the Veterans Health Administration Health Care System

2019 ◽  
Vol 35 (3) ◽  
pp. 308-318 ◽  
Author(s):  
Scott V. Adams ◽  
Michael J. Mader ◽  
Mary J. Bollinger ◽  
Edwin S. Wong ◽  
Teresa J. Hudson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Rural And Urban ◽  
Care System

scholarly journals Moving From Discovery to System-Wide Change: The Role of Research in a Learning Health Care System: Experience from Three Decades of Health Systems Research in the Veterans Health Administration

2017 ◽  
Vol 38 (1) ◽  
pp. 467-487 ◽  
Author(s):  
David Atkins ◽  
Amy M. Kilbourne ◽  
David Shulkin
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Clinical Care ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Scientific Enterprise ◽  
Systems Research ◽  
Learning Health Care System ◽  
Care System

The Veterans Health Administration is unique, functioning as an integrated health care system that provides care to more than six million veterans annually and as a home to an established scientific enterprise that conducts more than $1 billion of research each year. The presence of research, spanning the continuum from basic health services to translational research, has helped the Department of Veterans Affairs (VA) realize the potential of a learning health care system and has contributed to significant improvements in clinical quality over the past two decades. It has also illustrated distinct pathways by which research influences clinical care and policy and has provided lessons on challenges in translating research into practice on a national scale. These lessons are increasingly relevant to other health care systems, as the issues confronting the VA—the need to provide timely access, coordination of care, and consistent high quality across a diverse system—mirror those of the larger US health care system.

scholarly journals Simulation of “North Carolina Protocol for Allocating Scarce Inpatient Critical Care Resources in a Pandemic” in a Multi-hospital Health Care System

2021 ◽  
Vol 82 (1) ◽  
pp. 21-28
Author(s):  
Deborah J. Love ◽  
Lawrence R. Nycum ◽  
Tanya Stewart Blackmon ◽  
A.J. Patefield ◽  
Paula Bird ◽  
...  
Keyword(s):  
Health Care ◽  
North Carolina ◽  
Critical Care ◽  
Health Care System ◽  
Care System

Teletinnitus Program at the VA Gulf Coast Veterans Health Care System

2014 ◽  
Vol 4 (1) ◽  
pp. 23-29
Author(s):  
Constance Hilory Tomberlin
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Patient Care ◽  
Health Care System ◽  
Gulf Coast ◽  
New Technology ◽  
Cost Effective ◽  
Veterans Health ◽  
Potential Benefits ◽  
Care System

There are a multitude of reasons that a teletinnitus program can be beneficial, not only to the patients, but also within the hospital and audiology department. The ability to use technology for the purpose of tinnitus management allows for improved appointment access for all patients, especially those who live at a distance, has been shown to be more cost effective when the patients travel is otherwise monetarily compensated, and allows for multiple patient's to be seen in the same time slots, allowing for greater access to the clinic for the patients wishing to be seen in-house. There is also the patient's excitement in being part of a new technology-based program. The Gulf Coast Veterans Health Care System (GCVHCS) saw the potential benefits of incorporating a teletinnitus program and began implementation in 2013. There were a few hurdles to work through during the beginning organizational process and the initial execution of the program. Since the establishment of the Teletinnitus program, the GCVHCS has seen an enhancement in patient care, reduction in travel compensation, improvement in clinic utilization, clinic availability, the genuine excitement of the use of a new healthcare media amongst staff and patients, and overall patient satisfaction.

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