Clinician Burnout and Social Determinants

Study Overview
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Brief Summary
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Although clinicians recognize the impact of the social determinants of health (SDH) on patient care, clinicians feel they do not have the time or knowledge to effectively address patients' unmet social needs in the clinic. This can lead to feelings of distress and helplessness. The objective of this study is to test the impact of a tablet-based platform that enhances the role of support staff to address SDH on clinician burnout.

Detailed Description
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Clinician burnout has risen over the last decade, and studies have found that almost 50% of U.S. physicians show signs of burnout. Burnout is characterized by emotional exhaustion, feelings of cynicism, and patient detachment. Clinicians at the front lines of care, such as family medicine and internal medicine, are at highest risk, and burnout is associated with an increased risk of cardiovascular disease, alcoholism, and suicide. Burnout also negatively impacts patient care. The drivers of burnout are complex, and a growing body of research has focused on developing strategies to address both clinician and organizational factors. One potential contributor to clinician burnout that has received less attention is their patients' SDH. The SDH, or the circumstances in which people are born, grow, live, and age, have a profound impact on morbidity and mortality. Increasingly, national organizations have called for healthcare systems to address SDH, such as food and housing insecurity, to improve population health. Although clinicians recognize the importance of SDH on patient care, clinicians feel they do not have the time, knowledge, or tools to effectively address SDH, which can leading to feelings of distress and helplessness in addressing patients' unmet social needs. The SDH can lead to increased patient complexity and clinician workload. Also, the seemingly insurmountable social needs faced by many patients are a major contributor to the decline in medicine residents choosing a career in primary care. Thus, the lack of a tool to assist the primary care team in addressing SDH is a critical problem that can negatively affect both patients and clinicians. Our long-term goal is to enhance the primary care teams' ability to address the SDH by utilizing a mobile health tool that can assist the team in addressing patients' unmet social needs in clinical settings. Mobile health tools, such as tablets, have shown promise in reducing disparities in care and addressing unmet social needs in pediatric practices. However, there is little data about how addressing SDH affects physician burnout. Mobile health tools have the potential to collect patient-reported data and connect patients to appropriate support personnel without interfering with clinic workflow and enhance the primary care teams' ability to provide patients with resources. The objective of this study is to test the impact of a tablet-based platform that enhances the role of support staff to address SDH on clinician burnout.

Official Title
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Addressing Social Determinants of Health to Reduce Physician Burnout

Conditions
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Burnout, Professional

Intervention / Treatment
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* Other: Tablet-based SDH tool


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All clinicians and primary care teams at participating sites will be eligible Exclusion Criteria: There are no specific exclusion criteria
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention sites-Tablet-based SDH tool<br>All clinicians and primary care teams at a practice that are randomized to the intervention will receive the tablet-based SDH tool. | Other: Tablet-based SDH tool<br>* A tablet-based SDH tool, which integrates responses into the EpicCare electronic health record (EHR).<br>|
| No Intervention: Control sites<br>Care as usual, no tablet-based SDH tool. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mini-Z Scale | This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome. | Baseline | 
| Mini-Z Scale | This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome. | 6 month post baseline | 
| Mini-Z Scale | This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome. | 12 month post baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of clinicians who report a joyful workplace |  | Baseline | 
| The number of clinicians who report a joyful workplace |  | 6 months post baseline | 
| The number of clinicians who report a joyful workplace |  | 12 months post baseline | 
| The number of clinicians who report a supportive practice |  | Baseline | 
| The number of clinicians who report a supportive practice |  | 6 months post baseline | 
| The number of clinicians who report a supportive practice |  | 12 months post baseline | 
| The number of clinicians who report a good work pace |  | Baseline | 
| The number of clinicians who report a good work pace |  | 6 months post baseline | 
| The number of clinicians who report a good work pace |  | 12 months post baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Physician Burnout, social determinants of health, Mini-Z