Cultural And Structural Features Of Zero-Burnout Primary Care Practices

Although much attention has been focused on individual-level drivers of burnout in primary care settings, examining the structural and cultural factors of practice environments with no burnout could identify solutions. In this cross-sectional analysis of survey data from 715 small-tomedium-size prim...

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Bibliographic Details
Published in:Health affairs (Millwood, Va.) Va.), 2021-06, Vol.40 (6), p.928-9
Main Authors: Edwards, Samuel T, Marino, Miguel, Solberg, Leif I, Damschroder, Laura, Stange, Kurt C, Kottke, Thomas E, Balasubramanian, Bijal A, Springer, Rachel, Perry, Cynthia K, Cohen, Deborah J
Format: Article
Language:English
Subjects:
Accountable care organizations
Burnout
Cross-sectional studies
Cultural factors
Culture
Demonstration projects
Electronic health records
Health care
Individual differences
Initiatives
Leadership
Medical practices
Polls & surveys
Primary care
Professional development
Psychological safety
Quality control
Quality improvement
Quality management
Regression analysis
Response rates
Work environment
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Summary:Although much attention has been focused on individual-level drivers of burnout in primary care settings, examining the structural and cultural factors of practice environments with no burnout could identify solutions. In this cross-sectional analysis of survey data from 715 small-tomedium-size primary care practices in the United States participating in the Agency for Healthcare Research and Quality's EvidenceNOW initiative, we found that zero-burnout practices had higher levels of psychological safety and adaptive reserve, a measure of practice capacity for learning and development. Compared with high-burnout practices, zero-burnout practices also reported using more quality improvement strategies, more commonly were solo and clinician owned, and less commonly had participated in accountable care organizations or other demonstration projects. Efforts to prevent burnout in primary care may benefit from focusing on enhancing organization and practice culture, including promoting leadership development and fostering practice agency.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2020.02391