384 - Factors Associated with Provider Shift Experience in an Academic Pediatric Emergency Department: A Novel Shift Satisfaction Score

Poster Number: 384
Publication Number: 384.314

Brooke Senken, Indiana University School of Medicine/Riley Hospital for Children, Indianapolis, IN, United States; Heather Kelker, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Cory Showalter, Indiana University School of Medicine Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States; Julie Welch, Indiana University School of Medicine, Indianapolis, IN, United States; Kyra Reed, Indiana University School of Medicine, Indianapolis, IN, United States; Kyle Yoder, Indiana University School of Medicine, Indianapolis, IN, United States; Jillian K. Gorski, Lurie Children’s Hospital, Chicago, IL, United States; Paul Musey, Indiana University School of Medicine, Indianapolis, IN, United States

Background: Physician wellness is a multi-faceted construct involving engagement, fulfillment, and the absence of burnout. This study focused on the intersection of provider satisfaction and the clinical work environment in the emergency department (ED). 

Objective: The objective was to use a novel shift satisfaction score to identify common themes impacting the on-shift wellness of pediatric emergency medicine (PEM) providers.

Design/Methods: This descriptive study used an anonymous, electronic survey with two questions developed via a modified Delphi method.  Q1 “Overall, how satisfied are you with your shift today?” was rated on a 7-point Likert scale. Q2 “What are the main factors that you considered when rating your level of satisfaction with your shift today?” was an open-ended response. We obtained a voluntary response sampling of PEM providers at an academic pediatric trauma center. Data were managed with REDCap and Excel. Qualitative analysis using inductive thematic coding was performed. Quantitative analysis with chi-squared testing to determine theme association with shift satisfaction employed a top-two-box model for binary outcomes. Univariate logistic regression was used to determine association of shift satisfaction with role.

Results: From Oct 2020 to May 2021, 372 responses were analyzed, with 250 respondents reporting satisfaction on shift, and 120 respondents reporting dissatisfaction. Physicians (OR 1.72, p=0.037) and paramedic/techs (OR 1.94, p=0.076) were associated with higher shift satisfaction than nurses, although only physicians reached significance. Themes related to teamwork, teaching/learning, and no comment were positively and significantly associated with higher shift satisfaction scores (score 6-7). Themes related to external team interactions (consultants, admitting teams), equipment/stocking, staffing, acuity/complex patients, medical/trauma alert, and personal reasons were negatively and significantly associated with lower shift satisfaction scores (score 1-3).Conclusion(s): This pilot study identified work environment factors impacting provider shift satisfaction in a pediatric ED. Our findings imply that instituting practices that encourage quality team interactions, camaraderie, and opportunities for teaching and learning could positively impact satisfaction and wellness. In addition, attention to work environment improvements, such as staffing ratios and stocking, could mitigate on-shift dissatisfaction. Further, shift satisfaction data can guide future research examining correlations with other operational metrics and provider-based interventions.
Factors Associated with Provider Shift Satisfaction in a Pediatric Emergency Department