Pediatric Faculty Engagement and Associated Areas of Worklife After a COVID19 Surge

Abstract

Purpose

Healthcare organizations strive to increase physician engagement and decrease attrition. However, little is known about which specific worklife areas may be targeted to improve physician engagement or retention, especially after stressful events such as a COVID19 surge. Our objective was to identify demographic characteristics and worklife areas most associated with increased physician engagement and decreased intent to leave in pediatric faculty.

Patients and Methods

In September 2020, we conducted a cross-sectional survey of faculty at an academic, tertiary-care children’s hospital. A convenience and voluntary sampling approach was used. The survey included demographics, Maslach Burnout Index-Human Services Survey (MBI-HSS) and the Areas of Worklife Survey (AWS). The MBI-HSS was used to measure faculty engagement. The AWS measures satisfaction with six worklife areas (workload, control, reward, fairness, community, values). We used bivariate analyses to examine relationships between worklife areas and engagement and between worklife areas and intent to leave. We included multivariate logistic regression models to examine worklife areas most associated with increased work engagement and decreased intent to leave.

Results

Our response rate was 41% (113/274 participants). In bivariate analysis, engaged faculty reported higher satisfaction in all worklife areas. In multivariate analyses, positive perceptions of workload (odds ratio (OR) 2.83; 95% confidence interval (CI), 1.2–6.9), control (OR, 3.24; 95% CI 1.4–7.3), and community (OR, 6.07; 95% CI 1.9–18.7) were associated with engagement. Positive perceptions of values (OR, 0.07; 95% CI 0.02–0.32) and community (OR, 0.19; 95% CI 0.05–0.78) were negatively associated with intent to leave.

Conclusion

We found that positive perceptions of workload, control, and community were most associated with engagement. Alignment of values and increased sense of community were associated with decreased intent to leave. Our findings suggest specific worklife areas may be targeted to increase faculty engagement and retention.

Plain Language Summary

Physician engagement and retention are growing concerns for healthcare organizations. We conducted a cross-sectional survey of pediatric faculty after a COVID19 surge in 2020 to examine whether there are worklife areas highly associated with physician engagement and decreased intent to leave their current practice. We found that respondents with high positive perceptions of their workload, autonomy and community in their workplace were more likely to be engaged, and that respondents who felt that their values aligned with their organization’s values and felt a positive sense of community were less likely to report intent to leave the organization. Prioritizing improvements in physician workload, autonomy, and community, and recruiting physicians with similar values may be an effective strategy for organizations who desire to increase physician engagement and retention.

Keywords:

• physician burnout
• workforce
• physician well-being

Abbreviations

95% CI, 95% Confidence Interval; AAP, American Academy of Pediatrics; AWS, Areas of Worklife Survey; DEP, Depersonalization; EE, Emotional Exhaustion; MBI, Maslach Burnout Inventory; MBI-HSS, Maslach Burnout Inventory Human Services Survey; OR, Odds Ratio; PA, Personal Accomplishment; VIF, Variance Inflation Factors.

Disclosure

Dr Cabana is a member of the United States Preventive Services Task Force (USPSTF). This manuscript does not necessarily represent the views of the USPSTF. Dr Janet Serwint reports grants from NICHD, HRSA; Associate Editor for Pediatrics in Review Editorial Board, consultant for Cameron Kravitt Foundation, outside the submitted work. The remaining authors report no conflicts of interest in this work.