Afternoon ward rounds: bad for patients, bad for doctors?

Carpenter, Alexander; Vora, Sona M; Kestenbaum, Samantha; Thompson, Ameeka; Devine, Mark; Tenison, Emma; Quicke, E; Liang, Kate; Deibel, Francesca

doi:10.7861/futurehosp.6-2-118

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…Specifically, burnout may contribute to inefficiency that delays discharge planning. 38 Burnout has been reported to contribute to greater use of workarounds 39 and care left undone, 40 which could lead to higher infection rates 41 and prolonged stays. 42 Further, burned-out clinicians may experience problems engaging with families of critically ill patients, delaying important discussions on care planning for patients.…”

Section: Discussionmentioning

confidence: 99%

Critical Care Nurse Burnout in Veterans Health Administration: Relation to Clinician and Patient Outcomes

Mohr

Swamy

Wong

et al. 2021

American Journal of Critical Care

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Background Critical care nurses have a burnout rate among the highest of any nursing field. Nurse burnout may impact care quality. Few studies have considered how temporal patterns may influence outcomes. Objective To test a longitudinal model of burnout clusters and associations with patient and clinician outcomes. Methods An observational study analyzed data from annual employee surveys and administrative data on patient outcomes at 111 Veterans Health Administration intensive care units from 2013 through 2017. Site-level burnout rates among critical care nurses were calculated from survey responses about emotional exhaustion and depersonalization. Latent trajectory analysis was applied to identify clusters of facilities with similar burnout patterns over 5 years. Regression analysis was used to analyze patient and employee outcomes by burnout cluster and organizational context measures. Outcomes of interest included patient outcomes (30-day standardized mortality rate and observed minus expected length of stay) for 2016 and 2017 and clinician outcomes (intention to leave and employee satisfaction) from 2013 through 2017. Results Longitudinal analysis revealed 3 burnout clusters among the 111 sites: low (n = 37), medium (n = 68), and high (n = 6) burnout. Compared with sites in the low-burnout cluster, those in the high-burnout cluster had longer patient stays, higher employee turnover intention, and lower employee satisfaction in bivariate models but not in multivariate models. Conclusions In this multiyear, multisite study, critical care nurse burnout was associated with key clinician and patient outcomes. Efforts to address burnout among nurses may improve patient and employee outcomes.

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Section: Discussionmentioning

confidence: 99%

Critical Care Nurse Burnout in Veterans Health Administration: Relation to Clinician and Patient Outcomes

Mohr

Swamy

Wong

et al. 2021

American Journal of Critical Care

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“…1 Carpenter et al take a look at afternoon ward rounds and doubt their efficacy. 2 Many of us spend more time on ward rounds than undertaking our subspecialty work, and yet we have a dearth of evidence to guide how best to utilise this time.…”

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confidence: 99%

Change, change, change

Fox¹

2019

Future Healthcare Journal

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Factors affecting the UK junior doctor workforce retention crisis: an integrative review

Lock

Carrieri

2022

BMJ Open

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ObjectivesTo determine the factors contributing to the junior doctor workforce retention crisis in the UK using evidence collected directly from junior doctors, and to develop recommendations for changes to address the issue.DesignIntegrative review.Data sourcesSearches were conducted on Ovid Medline and HMIC to locate evidence published between January 2016 and April 2021. This was supplemented by publications from relevant national organisations.Eligibility criteriaEnglish-language papers relating to UK junior doctor retention, well-being or satisfaction which contained data collected directly from junior doctors were included. Papers focusing solely on the pandemic, factors specific to one medical specialty, evaluation of interventions, or numerical data with no evidence relating to causation were excluded. Review papers were excluded.Data extraction and synthesisData were extracted and coded on NVivo by FKL, then thematic analysis was conducted.Results47 papers were included, consisting of academic (qualitative, quantitative, mixed and commentary) and grey literature. Key themes identified were working conditions, support and relationships, and learning and development, with an overarching theme of lack of flexibility. The outcomes of these factors are doctors not feeling valued, lacking autonomy, having a poor work–life balance, and providing compromised patient care. This results in need for a break from medical training.ConclusionThis review builds on findings of related literature regarding working environments, isolation, stigma, and desire for autonomy, and highlights additional issues around learning and training, flexibility, feeling valued, and patient care. It goes on to present recommendations for tackling poor retention of UK junior doctors, highlighting that the complex problem requires evidence-based solutions and a bottom-up approach in which junior doctors are regarded as core stakeholders during the planning of interventions.

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Afternoon ward rounds: bad for patients, bad for doctors?

Cited by 3 publications

References 3 publications

Critical Care Nurse Burnout in Veterans Health Administration: Relation to Clinician and Patient Outcomes

Critical Care Nurse Burnout in Veterans Health Administration: Relation to Clinician and Patient Outcomes

Change, change, change

Factors affecting the UK junior doctor workforce retention crisis: an integrative review

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