Efficacy of the Well-Being Index to identify distress and stratify well-being in nurse practitioners and physician assistants

Abstract

Background and purpose: To evaluate the ability of the Well-Being Index (WBI) to stratify distress and well-being (high quality of life [QOL]) in nurse practitioners and physician assistants (NPs and PAs) and identify those whose degree of distress place them at an increased risk for medical error or turnover. Methods: A national sample of NPs and PAs completed a survey that included the WBI and instruments to measure QOL, fatigue, burnout, recent suicidal ideation, medical error, and intent to leave the current job. Conclusions: Overall, 1,576 of 4,106 (38.4%) NPs and PAs completed the survey. Those NPs and PAs with low mental QOL, extreme fatigue, recent suicidal ideation, or burnout had less favorable WBI scores (all p < .0001). Using a prevalence of low overall QOL among APPs of 14.4% as the pretest probability, the WBI score can reduce the posttest probability of low QOL to 2% or increase it to 64.7%. As the WBI score worsened, the posttest probability of high overall QOL decreased from 73% to 8.2%. Also, WBI score stratified the NPs and PAs likelihood of reporting recent medical errors and intent to leave his or her current job. Implications for practice: The WBI is a useful screening tool to stratify distress and well-being in APPs across a variety of domains and identify those NPs and PAs whose degree of distress may increase the risk of medical error or turnover.

Longitudinal Prospective Study of Emergency Medicine Provider Wellness Across Ten Academic and Community Hospitals During the Initial Surge of the COVID-19 Pandemic

“…WBI scores correlate other significant events such as medical error and intent to leave the job or profession. 28 – 32 …”

“…WBI scores correlate other signi cant events such as medical error and intent to leave the job or profession. [28][29][30][31][32] Physician Work Life Study (PWLS) burnout item is a validated tool asking participants to rate their level of selfde ned burnout (1 = "I enjoy my work"; 5 = "I am completely burned out"). Scores were dichotomized (1 or 2 = no burnout; 3 to 5 = burnout symptoms present).…”

Advanced Practice Provider Perspectives on Organizational Strategies for Work Stress Reduction

“…Research and a recent meta-analyses have substantiated the association of physician burnout to the quality of patient care and patient safety incidents (Dewa, Loong, Bonato, & Trojanowski, 2017; Panagioti et al, 2018). Dyrbye et al (2019) tested a well-being index with APPs and discovered substantial burnout symptoms and possible intent to leave their current position for 38.5% and 33% of the respondents, respectively. Organizational culture as a contributor to burnout is well known and there are concerns that the necessary focus on quality outcomes to meet regulatory standards may induce additional work stress on health care professionals (Montgomery, Todorova, Baban, & Panagopoulou, 2013).…”

“…APPs represent the least studied group of professionals for the syndrome of burnout and are comprised of advanced practice nurses and physician assistants (Dyrbye et al, 2019; Panagioti et al, 2018). The lack of APP-related research in the area of work stress, burnout, and engagement is due in part to role inception/development.…”

“…Detrimental effects associated with work stress among physicians and nurses are reported as substantially high, with some authors describing the prevalence of physician burnout as an epidemic, international in scope, and as a public health crisis (Panagioti et al, 2018; West, Dyrbye, & Shanafelt, 2018). Recent studies that include APPs as subjects have demonstrated that burnout exists as well in these providers with younger APPs and APP trainees more at risk (Dyrbye et al, 2019; Edwards et al, 2018; Orozco et al, 2019).…”