The Impact of Organizational Leadership on Physician Burnout and Satisfaction

Burnout, Professional Clinical Trial

Official title:

The Impact of Organizational Leadership on Physician Burnout and Satisfaction at The Ottawa Hospital

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04896307
• Other study ID #: 20200431-01H
• Status: Completed
• Start date: May 17, 2021
• Est. completion date: February 21, 2022

Study information

• Verified date: May 2022
• Source: University of Ottawa
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Physician burnout is a global issue characterized by emotional exhaustion, depersonalization, and low levels of personal accomplishment. Recent evidence suggests that organization-directed interventions were more likely to lead to reductions in burnout when compared to physician-directed interventions. More specifically, the leadership behaviors of the direct physician supervisor play a critical role in the well-being of physicians they supervise.

As such, the aims of this project are: 1) To improve our understanding of the prevalence of burnout and professional satisfaction of physicians working at the Ottawa Hospital (TOH), and 2) To evaluate the relationship between the leadership qualities of direct physician supervisors (i.e. Division and Department Heads) and the well-being and burnout of their physicians. Specifically, a cross-sectional survey will be completed by physicians at TOH to assess their levels of burnout and satisfaction and the leadership qualities of their direct physician supervisors.

Description:

Physician burnout is a global issue characterized by emotional exhaustion, depersonalization, and low levels of personal accomplishment. Burnout symptoms as high as 50% have been documented worldwide. According to the 2018 National Physician Health Survey, 30% of Canadian Physicians and Residents are experiencing burnout, with 26% high emotional exhaustion and 15% high depersonalization. Physician burnout is associated with low job satisfaction, decreased quality of patient care, reduced productivity, high job turnover, and early retirement from clinical practice. However, evidence suggests burnout is reversible and even preventable.

Recent evidence suggests that organization-directed interventions were more likely to lead to reductions in burnout when compared to physician-directed interventions. More specifically, the leadership behaviors of the direct physician supervisor play a critical role in the well-being of physicians they supervise. To date, we are unaware of any study that has examined the relationship between organizational leadership and degree of burnout and professional satisfaction in a Canadian tertiary care centre. Understanding physician burnout and professional satisfaction has strategic importance to the health of the physician, the patient, and the organization.

A recent study of 2813 physicians at the Mayo clinic found that each 1-point increase in supervisor's leadership score was associated with a 3.3% decrease in the likelihood of burnout and 9% increase in satisfaction of physicians. Furthermore, 11% and 47% of the variation of burnout and satisfaction, respectively, was attributed to the leadership rating of the physician's supervisor. The findings from this study further highlight the importance of prioritizing leadership as a key performance indicator, but it is necessary to first determine whether the Mayo Clinic's findings can be translated to a Canadian tertiary care centre.

As such, the aims of this project are: 1) To improve our understanding of the prevalence of burnout and professional satisfaction of physicians working at TOH, and 2) To evaluate the relationship between the leadership qualities of direct physician supervisors (i.e. Division and Department Heads) and the well-being and burnout of their physicians.

Our study will use Shanafelt et al's study as a guide to investigate leadership qualities at TOH. A cross-sectional online survey will be completed by physicians at TOH that will assess their levels of burnout and satisfaction and the leadership qualities of their direct physician supervisor.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 383
• Est. completion date: February 21, 2022
• Est. primary completion date: February 21, 2022
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• all physicians working at The Ottawa Hospital

Exclusion Criteria:

• none

Related Conditions & MeSH terms

• Burnout, Professional
• Burnout, Psychological
• Leadership
• Satisfaction

Intervention

Other:
• Survey
Survey

Locations

Country	Name	City	State
Canada	The Ottawa Hospital	Ottawa	Ontario

Sponsors (3)

Lead Sponsor	Collaborator
University of Ottawa	The Ottawa Hospital, The Ottawa Hospital Research Institute

Country where clinical trial is conducted

Canada, 

References & Publications (17)

Arigoni F, Bovier PA, Sappino AP. Trend of burnout among Swiss doctors. Swiss Med Wkly. 2010 Aug 9;140:w13070. doi: 10.4414/smw.2010.13070. eCollection 2010. — View Citation

Bianchi R, Schonfeld IS, Laurent E. Burnout-depression overlap: a review. Clin Psychol Rev. 2015 Mar;36:28-41. doi: 10.1016/j.cpr.2015.01.004. Epub 2015 Jan 17. Review. — View Citation

Canadian Medical Association. CMA National Physician Health Survey - A National Snapshot. October 2018.

Collier R. Physician burnout a major concern. CMAJ. 2017 Oct 2;189(39):E1236-E1237. doi: 10.1503/cmaj.1095496. — View Citation

Dewa CS, Jacobs P, Thanh NX, Loong D. An estimate of the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada. BMC Health Serv Res. 2014 Jun 13;14:254. doi: 10.1186/1472-6963-14-254. — View Citation

Dewa CS, Loong D, Bonato S, Thanh NX, Jacobs P. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res. 2014 Jul 28;14:325. doi: 10.1186/1472-6963-14-325. Review. — View Citation

Klein J, Grosse Frie K, Blum K, von dem Knesebeck O. Burnout and perceived quality of care among German clinicians in surgery. Int J Qual Health Care. 2010 Dec;22(6):525-30. doi: 10.1093/intqhc/mzq056. Epub 2010 Oct 8. — View Citation

Linzer M, Visser MR, Oort FJ, Smets EM, McMurray JE, de Haes HC; Society of General Internal Medicine (SGIM) Career Satisfaction Study Group (CSSG). Predicting and preventing physician burnout: results from the United States and the Netherlands. Am J Med. 2001 Aug;111(2):170-5. — View Citation

Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual. Vol 4: Consulting psychologists press Palo Alto, CA; 1996.

Panagioti M, Panagopoulou E, Bower P, Lewith G, Kontopantelis E, Chew-Graham C, Dawson S, van Marwijk H, Geraghty K, Esmail A. Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Intern Med. 2017 Feb 1;177(2):195-205. doi: 10.1001/jamainternmed.2016.7674. Review. — View Citation

Panagopoulou E, Montgomery A, Benos A. Burnout in internal medicine physicians: Differences between residents and specialists. Eur J Intern Med. 2006 May;17(3):195-200. — View Citation

Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career development international. 2009;14(3):204-220.

Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reeves D, Buskirk SJ, Sloan JA, Swensen SJ. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015 Apr;90(4):432-40. doi: 10.1016/j.mayocp.2015.01.012. Epub 2015 Mar 18. — View Citation

Shanafelt TD, Mungo M, Schmitgen J, Storz KA, Reeves D, Hayes SN, Sloan JA, Swensen SJ, Buskirk SJ. Longitudinal Study Evaluating the Association Between Physician Burnout and Changes in Professional Work Effort. Mayo Clin Proc. 2016 Apr;91(4):422-31. doi: 10.1016/j.mayocp.2016.02.001. — View Citation

Weng HC, Hung CM, Liu YT, Cheng YJ, Yen CY, Chang CC, Huang CK. Associations between emotional intelligence and doctor burnout, job satisfaction and patient satisfaction. Med Educ. 2011 Aug;45(8):835-42. doi: 10.1111/j.1365-2923.2011.03985.x. — View Citation

West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018 Jun;283(6):516-529. doi: 10.1111/joim.12752. Epub 2018 Mar 24. Review. — View Citation

Williams ES, Manwell LB, Konrad TR, Linzer M. The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: results from the MEMO study. Health Care Manage Rev. 2007 Jul-Sep;32(3):203-12. — View Citation

* Note: There are 17 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	2-item Maslach Burnout Inventory (MBI)	Burnout will be assessed by the 2-item version of the MBI.	Baseline
Primary	Satisfaction Questionnaire	Overall satisfaction with TOH as a health care organization will be evaluated with the following question, rated on a 5-point Likert scale from "very satisfied" to "very dissatisfied": "Considering everything, how would you rate your overall satisfaction with TOH as a whole at the present time?"	Baseline
Primary	12-Item Participatory Management Leadership Index	This validated questionnaire assesses the opinion of the leadership qualities of the physician's immediate supervisor. The 12 items assess specific characteristics of leadership that are measurable and actionable. Participants will also be asked to rate their overall satisfaction with their immediate supervisor on a 5-point Likert scale from "very satisfied" to "very dissatisfied".	Baseline