416 - Pediatric Provider’s Barriers and Facilitators to Achieving Well-Being

Poster Number: 416
Publication Number: 416.445

Whitney Marvin, MUSC Children's Hospital, Charleston, SC, United States; Jillian Harvey, Medical University of South Carolina, Charleston, SC, United States; Natasha M. Ruth, Medical University of South Carolina College of Medicine, Charleston, SC, United States

Background: The pendulum between burnout and provider engagement is driven by a multitude of factors that have been altered during the COVID-19 pandemic. Pediatricians reported burnout was increasing prior to the pandemic and since the onset, there has been an increase in stress disorders, anxiety, and depression among all healthcare workers.

Objective: To determine drivers and roadblocks of well-being at our institution and to share this data with leadership to allow for actionable change.

Design/Methods: We used a qualitative multi-methods study of attendings and advanced practice pediatric providers at a tertiary care academic center. Eight, three-hour virtual focus groups were held via Microsoft Teams to discuss key drivers and barriers to well-being (October 2020-April 2021). We collected demographic and burnout data via REDCap. Analysis utilized a general inductive approach. The initial coding scheme builds on the Mayo Framework of key drivers for physician burnout and engagement. Focus groups were transcribed verbatim, and coded line by line by three researchers, one with qualitative expertise and two with expertise in physician well-being.

Results: 83 physicians and advanced practice providers participated. Most of our participants were married, worked fulltime and had young children. Providers were asked to self-report their current level of burnout. The majority of participants reported a significant level of burnout with the largest frequency noted at a level 8 (Figure 1). The main promoters of well-being were the shift to telehealth, the ability to work remotely, working with trainees, serving as a mentor, hiring good people, social support within divisions and from leadership, and the new focus on self-care. The major contributors to burnout included working holidays, heavy workloads, administrative and email task burden, increased psychiatric patient loads, lack of control over finances, schedule and work hours, lack of perceived physical safety at work, lack of childcare, pull between work and family obligations, a culture of not taking vacation, lack of mentorship, declined social gatherings, a culture of avoidance, perceived mismatch between organizational goals and day-to-day provision of care, and a seemingly punitive compensation plan.Conclusion(s): This study provides insight into modifiable factors that promote and inhibit well-being at an academic institution during a pandemic. Well-being has been positively impacted by increased autonomy in scheduling and through the shift to virtual conference attendances.
Figure 1: Burnout RankingSelf Reported Burnout Ranking. On a scale of 0-10, with 10 being the highest level of burnout, where would you rank yourself today?