BACKGROUND AND OBJECTIVE: Data describing factors associated with work–life balance, burnout, and career and life satisfaction for early career pediatricians are limited. We sought to identify personal and work factors related to these outcomes. METHODS: We analyzed 2013 survey data of pediatricians who graduated residency between 2002 and 2004. Dependent variables included: (1) balance between personal and professional commitments, (2) current burnout in work, (3) career satisfaction, and (4) life satisfaction. Multivariable logistic regression examined associations of personal and work characteristics with each of the 4 dependent variables. RESULTS: A total of 93% of participants completed the survey (n = 840). A majority reported career (83%) and life (71%) satisfaction. Fewer reported current appropriate work–life balance (43%) or burnout (30%). In multivariable modeling, excellent/very good health, having support from physician colleagues, and adequate resources for patient care were all found to be associated with a lower prevalence of burnout and a higher likelihood of work–life balance and career and life satisfaction. Having children, race, and clinical specialty were not found to be significantly associated with any of the 4 outcome measures. Female gender was associated with a lower likelihood of balance and career satisfaction but did not have an association with burnout or life satisfaction. CONCLUSIONS: Burnout and struggles with work–life balance are common; dissatisfaction with life and career are a concern for some early career pediatricians. Efforts to minimize these outcomes should focus on encouragement of modifiable factors, including health supervision, peer support, and ensuring sufficient patient care resources.
Handoff miscommunications are a leading source of medical errors. Harmful medical errors decreased in pediatric academic hospitals following implementation of the I-PASS handoff improvement program. However, implementation across specialties has not been assessed.
To compare pediatrician career satisfaction and wellbeing by sex during the coronavirus disease 2019 pandemic with prepandemic years using longitudinal survey data.
Handoff miscommunications are a leading source of medical errors. Error rates decreased following implementation of the I-PASS handoff program (a bundled intervention using a structured mnemonic, I-PASS, and other initiatives to sustain implementation) in a pediatric research trial. Whether I-PASS can be implemented in settings outside academic pediatric institutions is unknown.
Objectives
To implement I-PASS in a variety of hospitals and medical specialties using a mentored process. (2) To measure the association of I-PASS implementation with handoff quality and provider-reported medical error rates.
Methods
We implemented I-PASS in 16 hospitals [community (n=5), academic (n=11)] and multiple specialties [internal medicine (n=7), pediatrics (n=3), other (n=6)]. We paired each site with an external mentorship team of I-PASS experts that conducted a site visit and provided ongoing coaching. Site leads participated in program wide webinars and shared data with participating sites. Validated handoff observation tools and a provider survey assessed handoff quality and rates of adverse events.
Results
Implementation was associated with increased inclusion of all 5 I-PASS mnemonic elements for both verbal (14% vs 70%) and written (0% vs 81%) handoffs. Additionally, increases were noted in the frequency of high quality verbal (44% vs 81%) and written (49% vs 73%) patient summaries, verbal (22% vs 82%) and written (44% vs 72%) contingency plans, and verbal receiver syntheses (4% vs 81%). Adverse events decreased by 27%. All changes statistically significant. Improvements were similar across provider types and settings.
Conclusions
The I-PASS Handoff program is associated with improved handoff communication in a variety of settings and provider types.