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Creighton University study to address physician burnout by deepening connection to patients

ACGME grant helps residents spend more time at bedside to improve well-being and medical outcomes

Patients see physicians to address issues with their well-being, but a new study by Creighton University’s School of Medicine will investigate if increasing time spent at bedside with patients increases the well-being of the health care professional, too.

The Accreditation Council for Graduate Medical Education (ACGME) awarded Creighton University’s School of Medicine a grant for its C.H.E.E.R. Study: Bringing Cheer Back to the Bedside.

Creighton is one of 30 organizations in the nation that had a project selected for ACGME’s Back to Bedside grant, a resident-led initiative that aims to empower the medical community to increase time with patients within a health care environment in which patient care and academic learning is more commonly occurring away from the patient’s bedside.

Under the mentorship of Dr. Prasanna Tadi, an assistant professor in Creighton University’s School of Medicine and neurologist with CHI Health, residents have been involved in the development of the study. Drs. Elizabeth George, Janani Baskaran, Sawson Abulaimon, Alheli Arce Gastelum, Daniela Iliescu, Anusha Pinjala, Sara Albagoush, Venkat Pajjuru and Syed Haque will facilitate some of the first research into how to address “physician burnout,” a priority issue in the national medical community. This project is also supported by the Internal Medicine program director Dr. Joseph Nahas; associate program director Dr. Mohsin Mirza; and faculty mentors Dr. Andukuri and Dr. Embach.

According to the National Academy of Medicine, burnout among physicians is nearly two times as high among United States physicians compared to any other field. More concerning, 400 physicians commit suicide every year, a rate that is more than double that of the general population.

“At any national conference you attend now, burnout is the hot topic because it is worsening across the board,” Dr. Tadi said. “For a doctor, a health care system or medical school, the shared goal is to provide better patient care, but burnout negatively affects the quality of care provided. The purpose of our study is to bring back cheer and meaning in the clinical learning environment that can lead to better resident well-being and patient outcomes.”

Burnout reduces patient satisfaction, as well as physician productivity and effort, and it increases medical errors, turnover and medical costs. It is pervasive throughout the entire health care spectrum, Dr. Tadi said. A unique aspect of the Creighton study is its wide reach. In addition to residents and physicians, medical students, pharmacists, physical therapists, occupational therapists, dentists and nurses will participate in the study. Their well-being will be measured by the Mayo Clinic Resident/Fellow Well-Being Index score from July 2019 to June 2021. Study analysis will be provided semiannually to ACGME.

“Our hope is that with this study we will be able to show improvement in multiple areas of well-being and relieve the pressures physicians are facing,” Dr. Tadi said. “We are trying to change the culture of patient care locally, but it has the potential to make a big impact across multiple disciplines nationally.”

Creighton University’s C.H.E.E.R. study is intended to improve residents’ clinical learning environments by involving them in the process through a series of three interventions – C.H.E.E.R. Rounds, C.H.E.E.R. Meetings and C.H.E.E.R. Emails.

Rounds – A central intervention in which each of Creighton’s hospital medicine services (HMS) teams will select one patient with a complex medico-social background for a half-hour of screen-free time at the patient’s bedside. The patient’s family is invited to bring personal photos of the patient to facilitate conversation and learn about the patient’s social background, hobbies and interests. The patient’s understanding of his/her health conditions and challenges in accessing health care will be discussed and all of the participating HMS teams will provide input. The goal of this first intervention is to cultivate a deeper resident-patient connection, enhance resident autonomy and interdisciplinary communication during these weekly sessions.

Meeting – The second intervention lasts 60 minutes, occurs monthly, and each letter of the C.H.E.E.R. acronym represents a part of the meeting format:

Celebrate – Patients celebrate their success and share their progress with residents.

Hearing – Residents hear the patient’s journey through hospitalization and review areas for improvement.

Expertise – Experts converse with residents regarding a specific wellness topic.

Engage – Residents engage by sharing their own ideas on the wellness topic.

Recharge – Residents discuss implementation of these ideas into their daily lives.

Emails – The third intervention involves twice monthly CHEER emails being sent to house staff and faculty, including information about upcoming CHEER meetings and recognizing the personal and professional accomplishments of the residents.

Medical organizations throughout the country are prioritizing evidence-based research on this topic, and our study is designed to establish a long-term connection with the patients, who are the reason we entered into the medical profession in the first place,” Dr. Tadi said.

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