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Primary Care Tasks Associated with Provider Burnout: Findings from a Veterans Health Administration Survey.
J Gen Intern Med. 2018 01; 33(1):50-56.JG

Abstract

BACKGROUND

The patient-centered medical home (PCMH) is a primary care delivery model predicated on shared responsibility for patient care among members of an interprofessional team. Effective task sharing may reduce burnout among primary care providers (PCPs). However, little is known about the extent to which PCPs share these responsibilities, and which, if any, of the primary care tasks performed independently by the PCPs (vs. shared with the team) are particularly associated with PCP burnout. A better understanding of the relationship between these tasks and their effects on PCP burnout may help guide focused efforts aimed at reducing burnout.

OBJECTIVE

To investigate (1) the extent to which PCPs share responsibility for 14 discrete primary care tasks with other team members, and (2) which, if any, of the primary care tasks performed by the PCPs (without reliance on team members) are associated with PCP burnout.

DESIGN

Secondary data analysis of Veterans Health Administration (VHA) survey data from two time periods.

PARTICIPANTS

327 providers from 23 VA primary care practices within one VHA regional network.

MAIN MEASURES

The dependent variable was PCP report of burnout. Independent variables included PCP report of the extent to which they performed 14 discrete primary care tasks without reliance on team members; team functioning; and PCP-, clinic-, and system-level variables.

KEY RESULTS

In adjusted models, PCP reports of intervening on patient lifestyle factors and educating patients about disease-specific self-care activities, without reliance on their teams, were significantly associated with burnout (intervening on lifestyle: b = 4.11, 95% CI = 0.39, 7.83, p = 0.03; educating patients: b = 3.83, 95% CI = 0.33, 7.32, p = 0.03).

CONCLUSIONS

Performing behavioral counseling and self-management education tasks without relying on other team members for assistance was associated with PCP burnout. Expanding the roles of nurses and other healthcare professionals to assume responsibility for these tasks may ease PCP burden and reduce burnout.

Authors+Show Affiliations

VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles (GLA) Healthcare System, Los Angeles, CA, USA. linyskim@ucla.edu.VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles (GLA) Healthcare System, Los Angeles, CA, USA.Department of Nursing Research, Cedars-Sinai Health System, Los Angeles, CA, USA.VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles (GLA) Healthcare System, Los Angeles, CA, USA. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles (GLA) Healthcare System, Los Angeles, CA, USA. RAND Corporation, Santa Monica, CA, USA.Section of General Internal Medicine, VA Portland Health Care System, Portland, OR, USA. Division of General Internal Medicine and Geriatrics, Oregon Health and Sciences University, Portland, OR, USA. Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, US Department of Veterans Affairs, Seattle, WA, USA. Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA.VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles (GLA) Healthcare System, Los Angeles, CA, USA. RAND Corporation, Santa Monica, CA, USA.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

28948450

Citation

Kim, Linda Y., et al. "Primary Care Tasks Associated With Provider Burnout: Findings From a Veterans Health Administration Survey." Journal of General Internal Medicine, vol. 33, no. 1, 2018, pp. 50-56.
Kim LY, Rose DE, Soban LM, et al. Primary Care Tasks Associated with Provider Burnout: Findings from a Veterans Health Administration Survey. J Gen Intern Med. 2018;33(1):50-56.
Kim, L. Y., Rose, D. E., Soban, L. M., Stockdale, S. E., Meredith, L. S., Edwards, S. T., Helfrich, C. D., & Rubenstein, L. V. (2018). Primary Care Tasks Associated with Provider Burnout: Findings from a Veterans Health Administration Survey. Journal of General Internal Medicine, 33(1), 50-56. https://doi.org/10.1007/s11606-017-4188-6
Kim LY, et al. Primary Care Tasks Associated With Provider Burnout: Findings From a Veterans Health Administration Survey. J Gen Intern Med. 2018;33(1):50-56. PubMed PMID: 28948450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary Care Tasks Associated with Provider Burnout: Findings from a Veterans Health Administration Survey. AU - Kim,Linda Y, AU - Rose,Danielle E, AU - Soban,Lynn M, AU - Stockdale,Susan E, AU - Meredith,Lisa S, AU - Edwards,Samuel T, AU - Helfrich,Christian D, AU - Rubenstein,Lisa V, Y1 - 2017/09/25/ PY - 2017/04/02/received PY - 2017/09/07/accepted PY - 2017/08/30/revised PY - 2017/9/28/pubmed PY - 2019/11/12/medline PY - 2017/9/27/entrez KW - health care delivery KW - health services research KW - patient centered care KW - primary care redesign KW - workforce SP - 50 EP - 56 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 33 IS - 1 N2 - BACKGROUND: The patient-centered medical home (PCMH) is a primary care delivery model predicated on shared responsibility for patient care among members of an interprofessional team. Effective task sharing may reduce burnout among primary care providers (PCPs). However, little is known about the extent to which PCPs share these responsibilities, and which, if any, of the primary care tasks performed independently by the PCPs (vs. shared with the team) are particularly associated with PCP burnout. A better understanding of the relationship between these tasks and their effects on PCP burnout may help guide focused efforts aimed at reducing burnout. OBJECTIVE: To investigate (1) the extent to which PCPs share responsibility for 14 discrete primary care tasks with other team members, and (2) which, if any, of the primary care tasks performed by the PCPs (without reliance on team members) are associated with PCP burnout. DESIGN: Secondary data analysis of Veterans Health Administration (VHA) survey data from two time periods. PARTICIPANTS: 327 providers from 23 VA primary care practices within one VHA regional network. MAIN MEASURES: The dependent variable was PCP report of burnout. Independent variables included PCP report of the extent to which they performed 14 discrete primary care tasks without reliance on team members; team functioning; and PCP-, clinic-, and system-level variables. KEY RESULTS: In adjusted models, PCP reports of intervening on patient lifestyle factors and educating patients about disease-specific self-care activities, without reliance on their teams, were significantly associated with burnout (intervening on lifestyle: b = 4.11, 95% CI = 0.39, 7.83, p = 0.03; educating patients: b = 3.83, 95% CI = 0.33, 7.32, p = 0.03). CONCLUSIONS: Performing behavioral counseling and self-management education tasks without relying on other team members for assistance was associated with PCP burnout. Expanding the roles of nurses and other healthcare professionals to assume responsibility for these tasks may ease PCP burden and reduce burnout. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/28948450/Primary_Care_Tasks_Associated_with_Provider_Burnout:_Findings_from_a_Veterans_Health_Administration_Survey_ DB - PRIME DP - Unbound Medicine ER -