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Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records.

Publication ,  Journal Article
McPeek-Hinz, E; Boazak, M; Sexton, JB; Adair, KC; West, V; Goldstein, BA; Alphin, RS; Idris, S; Hammond, WE; Hwang, SE; Bae, J
Published in: JAMA Netw Open
April 1, 2021

IMPORTANCE: Electronic health records (EHRs) are considered a potentially significant contributor to clinician burnout. OBJECTIVE: To describe the association of EHR usage, sex, and work culture with burnout for 3 types of clinicians at an academic medical institution. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study of 1310 clinicians at a large tertiary care academic medical center analyzed EHR usage metrics for the month of April 2019 with results from a well-being survey from May 2019. Participants included attending physicians, advanced practice providers (APPs), and house staff from various specialties. Data were analyzed between March 2020 and February 2021. EXPOSURES: Clinician demographic characteristics, EHR metadata, and an institution-wide survey. MAIN OUTCOMES AND MEASURES: Study metrics included clinician demographic data, burnout score, well-being measures, and EHR usage metadata. RESULTS: Of the 1310 clinicians analyzed, 542 (41.4%) were men (mean [SD] age, 47.3 [11.6] years; 448 [82.7%] White clinicians, 52 [9.6%] Asian clinicians, and 21 [3.9%] Black clinicians) and 768 (58.6%) were women (mean [SD] age, 42.6 [10.3] years; 573 [74.6%] White clinicians, 105 [13.7%] Asian clinicians, and 50 [6.5%] Black clinicians). Women reported more burnout (survey score ≥50: women, 423 [52.0%] vs men, 258 [47.6%]; P = .008) overall. No significant differences in EHR usage were found by sex for multiple metrics of time in the EHR, metrics of volume of clinical encounters, or differences in products of clinical care. Multivariate analysis of burnout revealed that work culture domains were significantly associated with self-reported results for commitment (odds ratio [OR], 0.542; 95% CI, 0.427-0.688; P < .001) and work-life balance (OR, 0.643; 95% CI, 0.559-0.739; P < .001). Clinician sex significantly contributed to burnout, with women having a greater likelihood of burnout compared with men (OR, 1.33; 95% CI, 1.01-1.75; P = .04). An increased number of days spent using the EHR system was associated with less likelihood of burnout (OR, 0.966; 95% CI, 0.937-0.996; P = .03). Overall, EHR metrics accounted for 1.3% of model variance (P = .001) compared with work culture accounting for 17.6% of variance (P < .001). CONCLUSIONS AND RELEVANCE: In this cross-sectional study, sex-based differences in EHR usage and burnout were found in clinicians. These results also suggest that local work culture factors may contribute more to burnout than metrics of EHR usage.

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Published In

JAMA Netw Open

DOI

EISSN

2574-3805

Publication Date

April 1, 2021

Volume

4

Issue

4

Start / End Page

e215686

Location

United States

Related Subject Headings

  • Work-Life Balance
  • Surveys and Questionnaires
  • Sex Distribution
  • Physicians
  • Middle Aged
  • Male
  • Job Satisfaction
  • Humans
  • Female
  • Electronic Health Records
 

Citation

APA
Chicago
ICMJE
MLA
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McPeek-Hinz, E., Boazak, M., Sexton, J. B., Adair, K. C., West, V., Goldstein, B. A., … Bae, J. (2021). Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records. JAMA Netw Open, 4(4), e215686. https://doi.org/10.1001/jamanetworkopen.2021.5686
McPeek-Hinz, Eugenia, Mina Boazak, J Bryan Sexton, Kathryn C. Adair, Vivian West, Benjamin A. Goldstein, Robert S. Alphin, et al. “Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records.JAMA Netw Open 4, no. 4 (April 1, 2021): e215686. https://doi.org/10.1001/jamanetworkopen.2021.5686.
McPeek-Hinz E, Boazak M, Sexton JB, Adair KC, West V, Goldstein BA, et al. Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records. JAMA Netw Open. 2021 Apr 1;4(4):e215686.
McPeek-Hinz, Eugenia, et al. “Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records.JAMA Netw Open, vol. 4, no. 4, Apr. 2021, p. e215686. Pubmed, doi:10.1001/jamanetworkopen.2021.5686.
McPeek-Hinz E, Boazak M, Sexton JB, Adair KC, West V, Goldstein BA, Alphin RS, Idris S, Hammond WE, Hwang SE, Bae J. Clinician Burnout Associated With Sex, Clinician Type, Work Culture, and Use of Electronic Health Records. JAMA Netw Open. 2021 Apr 1;4(4):e215686.

Published In

JAMA Netw Open

DOI

EISSN

2574-3805

Publication Date

April 1, 2021

Volume

4

Issue

4

Start / End Page

e215686

Location

United States

Related Subject Headings

  • Work-Life Balance
  • Surveys and Questionnaires
  • Sex Distribution
  • Physicians
  • Middle Aged
  • Male
  • Job Satisfaction
  • Humans
  • Female
  • Electronic Health Records