Article Figures & Data
Figures
- Figure 1.
Prevalence of burnout symptoms in community practices participating in the Garden Practice Transformation Network GPTN-Maryland Mini Z survey (n = 166). Numbers on the pie chart are number (percent) of participants in corresponding strata.
- Figure 2.
Contribution of Mini Z burnout drivers to the underlying structure of the time constraints/teamwork score (T/T) score. Data for 166 participants of the Garden Practice Transformation Network (GPTN)-Maryland Mini Z survey are shown. Exploratory factor analysis of the T/T score was conducted based on a principal component factoring method. Numbers on the graph correspond to the percent of variance in the T/T score explained by each factor.
- Figure 3.
Association between predicted probability of burnout and time constraints/teamwork score (T/T) score. Predicted probabilities of burnout derived from the ordinal logistic regression model are shown for 166 participants of the Garden Practice Transformation Network (GPTN)-Maryland Mini Z survey. Gray-shaded areas on the graph define 95% confidence intervals.
- Appendix Figure 1.
Word cloud for the open-ended responses about possible drivers of burnout. Data for 30 clinicians and staff who participated in the Garden Practice Transformation Network (GPTN)-Maryland Mini Z survey and provided written comments are shown. The size of the word is proportionate to its use frequency.
Tables
- Table 1.
Characteristics of the Garden Practice Transformation Network Maryland Clinicians and Staff Who Participated in the Mini Z Survey (n = 166)
Responders' Characteristics N (%) Role,* N (%) Providers 61 (36.7%) Clinical staff 27 (16.3%) Administrative 67 (40.4%) Unknown 11 (6.6%) Ownership, N (%) Employed 129 (78.7%) Owner 35 (21.3%) Practice size,†N (%) Solo 19 (11.5%) 2 to 5 71 (42.8%) 6 to 10 30 (18.1%) 11+ 46 (27.7%) Practice type,‡ N (%) Primary care 42 (25.3%) Specialist 124 (74.7%) - Table 2.
Spearman's Correlation Coefficients of Mini Z Items in the Garden Practice Transformation Network Maryland Clinicians and Staff (n = 166)
Job Satisfaction Control Time Pace* Values Team EHR at Home EHR Use Burnout 0.5922
<0.0001−0.4935
<0.0001−0.4248
<0.0001−0.3224
<0.0001−0.3266
<0.0001−0.3938
<0.0001−0.0707
0.3654−0.1122
0.1503Job satisfaction 1.000 0.4760
<0.00010.3914
<0.00010.2410
0.00180.4954
<0.00010.4721
<0.00010.0301
0.70040.2277
0.0032Control 1.000 0.6363
<0.00010.2118
0.00620.4428
<0.00010.4592
<0.00010.1823
0.01870.3048
<0.0001Time 1.000 0.08386
0.28270.32118
<0.00010.36644
<0.00010.28568
0.00020.19625
0.0113Pace* 1.000 0.173
0.02590.201
0.0093−0.172
0.0263−0.190
0.0142Value 1.000 0.5723
<0.0001−0.0001
0.99870.1940
0.0122Team 1.000 −0.0373
0.63340.1692
0.0293EHR at home 1.000 0.2273
0.0032Spearman's correlation coefficients and corresponding P values are shown. A 5-item burnout scale was coded so that the lowest score corresponded to the lowest burnout level (enjoyed work), and highest score corresponded to the highest level of burnout. The burnout drivers were coded so that score 1 corresponded to the lowest level of positive experience and score 5 corresponded to the highest level of positive experience, and recoded if necessary*. Mini Z burnout driver questions were formulated as followed: “Job satisfaction”— “Overall, I am satisfied with my current job, Strongly Disagree…Strongly Agree”; “Control”—“My control over workload is Poor…Optimal”; “Time”—“Sufficiency of time for documentation is Poor…Optimal”; “Pace”—“Which number best describes the atmosphere in your primary work area? Calm…Hectic/Chaotic”; “Values”—“My professional values are well aligned with those in my department leaders, Strongly Disagree…Strongly Agree”; “Team”—“The degree to which my care team works efficiently together is Poor…Optimal”; “EHR at home”—“The amount of time I spend on the electronic medical records (EHR) at home is Excessive…Optimal/None”; “EHR use”—“My proficiency with EHR use is Poor…Optimal.”
↵* Item “Pace” was reverse coded.
Responders' Characteristics Enjoy Work (n = 66) Stress, No Burnout (n = 74) Burnout (n = 36) P Value* N % N % N % Role,† N (%) Clinicians 17 (27.9%) 28 (45.9%) 16 (26.2%) 0.4600 Clinical staff 12 (44.4%) 12 (44.4%) 3 (11.1%) Administrative 23 (34.3%) 31 (46.3%) 13 (19.4%) Unknown 4 (36.4%) 3 (27.3%) 4 (36.4%) Ownership, N (%) Employed 45 (34.9%) 54 (41.9%) 30 (23.3%) 0.4561 Owner 10 (28.6%) 19 (54.3%) 6 (17.1%) Practice size,‡ N (%) Solo 7 (36.8%) 9 (47.4%) 3 (15.8%) 0.4128 2 to 5 21 (29.6%) 37 (52.1%) 13 (18.3%) 6 to 10 9 (30.0%) 14 (46.7%) 7 (23.3%) 11+ 19 (41.3%) 14 (30.4%) 13 (28.3%) Practice type,§ N (%) Primary care 14 (33.3%) 17 (40.5%) 11 (26.2%) 0.6989 Specialist 42 (33.9%) 57 (46.0%) 25 (20.2%) Data for 166 clinicians and staff who participated in the Garden Practice Transformation Network (GPTN)-Maryland Mini Z survey are shown.
↵* 2-sided Fisher's exact test.
↵† Providers: MD/DO, CRNP, PA; clinical staff: RN, MA.
↵‡ Number of prescribing providers.
↵§ Specialists included allergy and immunology, cardiology, dermatology, gastroenterology, ophthalmology, orthopedics, psychiatry.
Mini Z Items Provider (n = 61) Staff (n = 105) P Value* N % N % Overall, I am satisfied with my current job: Strongly disagree 1 (1.6%) 1 (1.0%) 0.6825F Disagree 4 (6.6%) 5 (4.8%) Neutral 10 (16.4%) 16 (15.2%) Agree 25 (41.0%) 54 (51.4%) Strongly agree 21 (34.4%) 29 (27.6%) My control over my workload is: Poor 3 (4.9%) 2 (1.9%) 0.1379 Marginal 13 (21.3%) 12 (11.4%) Satisfactory 14 (23.0%) 23 (21.9%) Good 22 (36.1%) 57 (54.3%) Optimal 9 (14.8%) 11 (10.5%) Sufficiency of time for documentation is: Poor 8 (13.1%) 3 (2.9%) 0.0138 Marginal 14 (23.0% 15 (14.3%) Satisfactory 16 (26.2%) 26 (24.8%) Good 21 (34.4%) 48 (45.7%) Optimal 2 (3.3%) 13 (12.4%) Which number best describes the atmosphere in your primary work area?† Hectic, chaotic 3 (4.9%) 7 (6.7%) 0.3741 12 (19.7% 27 (25.7%) Busy, but reasonable 33 (54.1%) 60 (57.1%) 6 (9.8%) 4 (3.8%) Calm 7 (11.5%) 7 (6.7%) My professional values are well aligned with those of my department leaders: Strongly disagree 1 (1.6%) 2 (1.9%) 0.2274F Disagree 4 (6.6%) 5 (4.8%) Neutral 15 (24.6%) 17 (16.2%) Agree 19 (31.2%) 51 (48.6%) Strongly agree 22 (36.1%) 30 (28.6%) The degree to which my care team works efficiently together is: Poor 2 (3.3%) 3 (2.9%) 0.5195 Marginal 5 (8.2%) 9 (8.6%) Satisfactory 8 (13.1%) 25 (23.8%) Good 28 (45.9%) 45 (42.9%) Optimal 18 (29.5%) 23 (21.9%) The amount of time I spend on the electronic health record (EHR) at home is: Excessive 9 (14.8% 0 (0.0%) <0.0001 Moderately high 16 (26.2%) 4 (3.8%) Satisfactory 10 (16.4%) 22 (21.0%) Modest 10 (16.4%) 10 (9.5%) Minimal/none 16 (26.2%) 69 (65.7%) My proficiency with EHR use is: Poor 1 (1.6%) 2 (1.9%) 0.0275F Marginal 4 (6.6%) 1 (1.0%) Satisfactory 19 (31.2%) 17 (16.2%) Good 23 (37.7%) 56 (53.3%) Optimal 14 (23.0%) 29 (27.6%)
