Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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4045 — Organizational and Social Determinants of Burnout among PACT Personnel

Lead/Presenter: Michelle Lampman, COIN - Iowa City
All Authors: Lampman MA (VISN 23 PACT Demonstration Lab) Fox MJ (VISN 23 PACT Demonstration Lab) Stewart GL (VISN 23 PACT Demonstration Lab)

Objectives:
Previous research has found that Patient Aligned Care Team (PACT) members experience significant burnout--a condition characterized by emotional exhaustion, depersonalized work relationships, and feeling of professional inefficiency. We extend this work through qualitative analysis that identifies organizational and social determinants of burnout.

Methods:
We collected data through an open-ended item inviting respondents to "provide feedback or comments regarding the PACT program, its implementation, or any concerns" that was included in the 2016 Patient Aligned Care Team (PACT) Survey. Based on a review of the survey domains, related literature, and emerging issues, we coded and analyzed responses for common themes paying particular attention to experiences related to employee morale. A consensus process was used between the two qualitative researchers at various stages of the analysis and interpretation to validate research findings.

Results:
A total of 2,647 survey respondents provided feedback through the open-ended survey item, with 23% (n = 604) providing comments specifically related to employee morale. Three common themes emerged from these responses. First, PACT personnel experience role stress and overload often resulting from changes in organizational policies and shifting priorities, challenges with delegating tasks among teams, and increased administrative burden. Many respondents report having difficulty completing their daily tasks and struggling to integrate key features of the PACT model related to prevention and management into practice. Second, PACT personnel experience burden from insufficient staffing resulting from hiring difficulties, turnover, and lack of role coverage. Inadequate staffing and coverage increases workload across all roles and presents barriers to providing better care. Finally, many PACT personnel perceive a lack of leadership support and report experiencing anger and frustration, feelings of being undervalued, and job dissatisfaction due to their inability to provide better care for Veterans.

Implications:
Many PACT personnel share a perception that they are being asked to do more and more work without sufficient resources and support, which is leading to burnout.

Impacts:
Burnout has been identified as a major concern among the primary care workforce. Our findings augment previous quantitative research by identifying specific reasons why staff experience burnout.