A novel modality for real-time measurement of provider happiness. Issue 1 (24th February 2022)

• Record Type: Journal Article
• Authors: Carlile, Narath; Tantillo, Sarah; Brown, Michael; Bates, David W; Choudhry, Niteesh K
• Is Part Of: JAMIA open. Volume 5:Issue 1(2022)
• Publication Date: 2022-02-24
• Subjects: burnout -- quality of healthcare -- measurement -- healthcare provider; Medical informatics -- Periodicals; 610.285
• DOI: 10.1093/jamiaopen/ooac009
• Languages: English
• ISSNs: 2574-2531

Abstract

Abstract: Objective: Physician burnout is at epidemic proportions, impacts clinical outcomes, and is very costly. Although there is emerging data about effective interventions, most physicians at risk of burnout do not seek help. Survey-based measures exist which can quantify burnout within populations, but these are usually only administered episodically. We hypothesized that a novel modality for real-time measurement of happiness and stressors would be acceptable, scalable, and could provide new actionable insights. Materials: We developed a novel informatics system consisting of a networked smart button device, server, and analytics for measuring happiness, and stressors in real-time during clinical work. We performed an observational cohort study in 3 primary care clinics. Random and fixed effects modeling was used to analyze predictors of stress and happiness and we conducted a survey of usability and user acceptance of the novel system. Results: We captured 455 recordings across 392 provider days from 14 primary care providers. In total, 85% of users found the device easy to use, and 87% would recommend the system to their colleagues. Happiness and stressors were observed in all working hours of the day, with a 22% reduction in feeling (the proportion of happiness to stressors) across a clinical day. Discussion: We tested a novel system which providers found easy to use and enabled collection of detailed data. Limitations included being an observational study within a small number of clinics. A simple, unintrusive, scalable informatics system capable of measuring happiness, and stressors in real-time could be useful to healthcare organizations and teams. Lay Summary: Burnout is a maladaptive response to chronic stressors. Physician burnout is at epidemic proportions, impacts clinical outcomes, and is very costly. Survey-based measures exist which can quantify burnout within populations, but as yet we do not have real-time, scalable, system-wide signals (of stressors or satisfiers) which would allow organizations to implement and monitor interventions that might mitigate the development of burnout. We developed a novel informatics system consisting of a networked smart button device, server, and analytics for measuring happiness and stressors in real-time during clinical work. We tested this system in an observational study with doctors, nurse practitioners, and physician assistants in 3 different primary care clinics in our organization. Most of the users found the device easy to use and would recommend it to their colleagues. Two important implications of the study are that the system was acceptable to users and can be easily scaled allowing organizations to understand and evaluate the impact of wellbeing interventions, workflow and technology changes more quickly; and second that the detailed real-time data provide the opportunity to detect and address stress and happiness occurring during clinical work in new ways and allows for the possibility of proactive outreach. Limitations of the study include having a small number of providers in a limited number of clinics. A novel, scalable system capable of measuring happiness and stressors in real-time could be useful to healthcare organizations and teams in tackling the epidemic of burnout.