Joy in work for clinicians and staff: Identifying remedial predictors of burnout from the Mini Z survey

Abstract

Purpose: The CMS Transforming Clinical Practice Initiative (TCPI) provided coaching and learning support to practices during transition to new models of value-based care. Maryland ambulatory practices participated in the Garden Practice Transformation Network (GPTN) as a part of the TCPI. During practices assessment, we measured prevalence of burnout and identified its remediable predictors among GPTN-Maryland practices. Methods: A modified Mini Z tool survey was distributed among clinicians and staff in November 2018 - July 2019. Association between presence of burnout and burnout drivers was assessed using a Generalized Estimating Equation regression model for ordinal outcome. Results: Data from 166 responses were analyzed. Prevalence of burnout symptoms was 22%, with 35% enjoying their work. A 100-point Time Constraints/Teamwork (T/T) score was constructed using factors significantly associated with burnout symptoms. T/T score increase by 1 unit was associated with 10% increase in the odds of moving from the group experiencing burnout or stress to the group who found ‘joy in work’ (OR = 1.1, 95% CI 1.07, 1.13, p < 0.0001). Conclusions: The Mini Z-derived T/T score could be useful for quick assessment of the degree of burnout and identifying burnout drivers related to effective organizational structure and supportive teamwork in practice personnel.