Relationships of hospital-based emergency department culture to work satisfaction and intent to leave of emergency physicians and nurses

Lin, Blossom Yen-Ju; Wan, Thomas T. H.; Hsu, Chiao Po; Hung, Feng Ru; Juan, Chi Wen; Lin, Cheng Chieh

doi:10.1258/hsmr.2012.012011

Cited by 16 publications

(13 citation statements)

References 35 publications

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“…Although severe burnout is common for emergency physicians, most (>60%) are satisfied with their jobs [3]. We found that emergency physicians in religious hospitals did not report higher well-being than those at business-run hospitals which are different from the previous studies [26]. Although there was no difference in well-being ratings between doctors in medical centers and regional hospitals, the happiness index was higher for doctors at regional hospitals than medical centers.…”

Section: Discussioncontrasting

confidence: 63%

A survey of the perception of well-being among emergency physicians in Taiwan

Chen

Hsieh

et al. 2017

Tzu Chi Med J

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Objectives:The objective of this study is to investigate the feelings (well-being) of emergency physicians in Taiwan regarding their job and the relationship between these feelings and the work environment.Materials and Methods:A questionnaire was used to survey emergency physicians across Taiwan from January to June 2014. The questionnaire contents were categorized into five specific factors that could affect well-being, including “emergency quality, emergency safety, support environment, workload, and salary and benefits.” Well-being was rated directly on a scale of 1–10, with 10 indicating the highest level of happiness. Physician retention was also surveyed. The correlations among the five factors, well-being, and physician retention were analyzed. The five factors were quantified as a “happiness index” and compared between religious and nonreligious hospitals and medical centers and regional hospitals.Results:A total of 398 questionnaires were received, and the response rate was 39%. Of these, 42.7% of responders reported high ratings for well-being (scores of 7–10, 1 is the worse, and 10 is the best) and 40.3% felt neutral (scores of 5–6). Only 12.3% doctors did not think they would stay at the same position for the next 3 years. All five factors had moderately significant correlations with each other (γ = 0.195–0.534, P < 0.01). All five factors also significantly correlated with well-being. Emergency safety (γ = 0.121, P < 0.05), salary and benefits (γ = 0.143, P < 0.05), and well-being (γ = 0.189, P < 0.01) were correlated with physician retention. The happiness indices of emergency quality, support environment, and workload were significantly higher in regional hospitals than medical centers.Conclusions:All five indicators had impacts on well-being. The respondents reported heavy workloads, including high stress and even poorly met physiological needs. In addition, the threat of violence, salaries, and well-being correlated with physician retention. Hospital administrators can make efforts to improve the well-being of doctors and physician retention by adjusting environmental factors.

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Section: Discussioncontrasting

confidence: 63%

A survey of the perception of well-being among emergency physicians in Taiwan

Chen

Hsieh

et al. 2017

Tzu Chi Med J

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“…Four studies used a single-centre approach [ 35 , 37 , 41 , 59 ]. Multi-centre designs varied in eight studies with 2 to 10 EDs [ 28 , 31 , 34 , 36 , 39 , 51 , 57 , 58 ], nine studies with 11 to 20 EDs [ 21 , 29 , 30 , 38 , 43 , 50 , 53 , 55 , 56 ], and three studies with 112 to 168 EDs [ 27 , 49 , 52 ]. Fifteen studies did not provide information on the number of surveyed EDs [ 22 – 26 , 32 , 33 , 40 , 42 , 44 – 48 , 54 ].…”

Section: Resultsmentioning

confidence: 99%

Associations between psychosocial work factors and provider mental well-being in emergency departments: A systematic review

Schneider

Weigl

2018

PLoS ONE

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BackgroundEmergency departments (ED) are complex and dynamic work environments with various psychosocial work stressors that increase risks for providers’ well-being. Yet, no systematic review is available which synthesizes the current research base as well as quantitatively aggregates data on associations between ED work factors and provider well-being outcomes.ObjectiveWe aimed at synthesizing the current research base on quantitative associations between psychosocial work factors (classified into patient-/ task-related, organizational, and social factors) and mental well-being of ED providers (classified into positive well-being outcomes, affective symptoms and negative psychological functioning, cognitive-behavioural outcomes, and psychosomatic health complaints).MethodsA systematic literature search in eight databases was conducted in December 2017. Original studies were extracted following a stepwise procedure and predefined inclusion criteria. A standardized assessment of methodological quality and risk of bias was conducted for each study with the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project. In addition to a systematic compilation of included studies, frequency and strength of quantitative associations were synthesized by means of harvest plots. Subgroup analyses for ED physicians and nurses were conducted.ResultsN = 1956 records were retrieved. After removal of duplicates, 1473 records were screened for titles and abstracts. 199 studies were eligible for full-text review. Finally, 39 original studies were included whereof 37 reported cross-sectional surveys. Concerning the methodological quality of included studies, the majority was evaluated as weak to moderate with considerable risk of bias. Most frequently surveyed provider outcomes were affective symptoms (e.g., burnout) and positive well-being outcomes (e.g., job satisfaction). 367 univariate associations and 370 multivariate associations were extracted with the majority being weak to moderate. Strong associations were mostly reported for social and organizational work factors.ConclusionsTo the best of our knowledge, this review is the first to provide a quantitative summary of the research base on associations of psychosocial ED work factors and provider well-being. Conclusive results reveal that peer support, well-designed organizational structures, and employee reward systems balance the negative impact of adverse work factors on ED providers’ well-being. This review identifies avenues for future research in this field including methodological advances by using quasi-experimental and prospective designs, representative samples, and adequate confounder control.Trial registrationProtocol registration number: PROSPERO 2016 CRD42016037220

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“…In the periphery of performance measurement focus, treatment services are performed by the employee, who is an essential resource for maintaining the daily operations. High quality treatment and optimal patient flow correlates with a high level of employee contentment, low turnover, and great seniority [41]. …”

Section: Discussionmentioning

confidence: 99%

Evaluation of emergency department performance – a systematic review on recommended performance and quality-in-care measures

Sørup

Jacobsen

Forberg

2013

Scand J Trauma Resusc Emerg Med

109

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BackgroundEvaluation of emergency department (ED) performance remains a difficult task due to the lack of consensus on performance measures that reflects high quality, efficiency, and sustainability.AimTo describe, map, and critically evaluate which performance measures that the published literature regard as being most relevant in assessing overall ED performance.MethodsFollowing the PRISMA guidelines, a systematic literature review of review articles reporting accentuated ED performance measures was conducted in the databases of PubMed, Cochrane Library, and Web of Science. Study eligibility criteria includes: 1) the main purpose was to discuss, analyse, or promote performance measures best reflecting ED performance, 2) the article was a review article, and 3) the article reported macro-level performance measures, thus reflecting an overall departmental performance level.ResultsA number of articles addresses this study’s objective (n = 14 of 46 unique hits). Time intervals and patient-related measures were dominant in the identified performance measures in review articles from US, UK, Sweden and Canada. Length of stay (LOS), time between patient arrival to initial clinical assessment, and time between patient arrivals to admission were highlighted by the majority of articles. Concurrently, “patients left without being seen” (LWBS), unplanned re-attendance within a maximum of 72 hours, mortality/morbidity, and number of unintended incidents were the most highlighted performance measures that related directly to the patient. Performance measures related to employees were only stated in two of the 14 included articles.ConclusionsA total of 55 ED performance measures were identified. ED time intervals were the most recommended performance measures followed by patient centeredness and safety performance measures. ED employee related performance measures were rarely mentioned in the investigated literature. The study’s results allow for advancement towards improved performance measurement and standardised assessment across EDs.

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Relationships of hospital-based emergency department culture to work satisfaction and intent to leave of emergency physicians and nurses

Cited by 16 publications

References 35 publications

A survey of the perception of well-being among emergency physicians in Taiwan

A survey of the perception of well-being among emergency physicians in Taiwan

Associations between psychosocial work factors and provider mental well-being in emergency departments: A systematic review

Evaluation of emergency department performance – a systematic review on recommended performance and quality-in-care measures

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