The Impact of Organizational Leadership on Physician Burnout and Satisfaction

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Burnout, Professional, Satisfaction, Leadership

Intervention / Treatment
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* Other: Survey


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all physicians working at The Ottawa Hospital Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Physicians at The Ottawa Hospital<br>Online survey completed by physicians working at The Ottawa Hospital consisting of the 2-item Maslach Burnout Inventory, a Satisfaction Questionnaire and the 12-Item Participatory Management Leadership Score. | Other: Survey<br>* Survey<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 2-item Maslach Burnout Inventory (MBI) | Burnout will be assessed by the 2-item version of the MBI. | Baseline | 
| 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 | 
| 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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burnout, satisfaction, organizational leadership, survey