Clinician Burnout and Social Determinants

Sponsor

Wake Forest University Health Sciences (Other)

Overall Status

Completed

CT.gov ID

NCT04070456

Collaborator

(none)

Enrollment

Locations

Arms

23.4

Actual Duration (Months)

11.3

Patients Per Site

0.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

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.

Condition or Disease	Intervention/Treatment	Phase
Burnout, Professional	Other: Tablet-based SDH tool	N/A

Detailed Description

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.

Study Design

Study Type:

Interventional

Actual Enrollment :

34 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Health Services Research

Official Title:

Addressing Social Determinants of Health to Reduce Physician Burnout

Actual Study Start Date :

Nov 18, 2019

Actual Primary Completion Date :

Jul 31, 2021

Actual Study Completion Date :

Oct 29, 2021

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Intervention sites-Tablet-based SDH tool 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 A tablet-based SDH tool, which integrates responses into the EpicCare electronic health record (EHR).
No Intervention: Control sites Care as usual, no tablet-based SDH tool.

Arm

Intervention/Treatment

Experimental: Intervention sites-Tablet-based SDH tool

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

A tablet-based SDH tool, which integrates responses into the EpicCare electronic health record (EHR).

No Intervention: Control sites

Care as usual, no tablet-based SDH tool.

Outcome Measures

Primary Outcome Measures

Mini-Z Scale [Baseline]
This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome.
Mini-Z Scale [6 month post baseline]
This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome.
Mini-Z Scale [12 month post baseline]
This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome.

Secondary Outcome Measures

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]

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

All clinicians and primary care teams at participating sites will be eligible

Exclusion Criteria:

There are no specific exclusion criteria

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Wake Forest Downtown Health Plaza (DHP)	Winston-Salem	North Carolina	United States	27101
2	Family Medicine-Piedmont Plaza	Winston-Salem	North Carolina	United States	27104
3	Internal Medicine-Janeway Tower	Winston-Salem	North Carolina	United States	27157