Jeffrey Silver Humanism in Healthcare Research Roundup – September 2016

The Jeffrey Silver Humanism in Healthcare Research Roundup features summaries of recently published studies on humanism in healthcare. To receive email notification of new studies once per month, enter your information here and select “Jeffrey Silver Research Roundup” from the checkboxes at the bottom. See previous posts in this series.


Publications from Gold Foundation-Affiliated Authors

Interventions to prevent and reduce physician burnout: A systematic review and meta-analysis
West C, Dyrbye L, Erwin P, Shanafelt D.   Lancet. 2016 Sep 28.
This paper was supported by a Mapping the Landscape, Journeying Together grant from the Arnold P. Gold Foundation Research Institute.
Authors identified 15 randomized and 37 cohort studies of interventions to prevent and reduce physician burnout. The literature indicates that both individual and organisational strategies can result in clinically meaningful reductions in burnout among physicians.Overall burnout decreased from 54% to 44%. Read blog post about this study

Doing something about physician burnout (commentary on article above)
Epstein RM, Privitera M. Lancet. 2016 Sep 28.
Dr. Epstein is a Mapping the Landscape, Journeying Together grant recipient.
Addressing burnout on an individual level will not be enough in the current health-care environment. Leaders at health-care institutions should take a careful look at what promotes joy, effectiveness, and engagement with clinical practice among their staff. They should take positive action now that West and colleagues have described effective models that have been implemented successfully.

Effect of a patient-centered communication intervention on oncologist-patient communication, quality of life, and health care utilization in advanced cancer: The VOICE randomized clinical trial
Epstein RM, Duberstein PR, Fenton JJ, Fiscella K, Hoerger M, et al.    JAMA Oncol. 2016 Sep 9.
Dr. Epstein is a Mapping the Landscape, Journeying Together grant recipient.
Researchers conducted a cluster randomized control trial with 38 oncologists and 265 cancer patients. Oncologists and patients received interventions focused on how to engage in patient-centered communication. The intervention resulted in clinically and statistically significant improvements in patient-centered communication but did not affect secondary outcomes.

Narrative medicine workshops for obstetrics and gynecology residents and association with burnout measures
Winkel AF, Feldman N, Moss H, Jakalow H, Simon J, Blank S.    Obstet Gynecol. 2016 Oct;128 Suppl 1:27S-33S.
Dr. Winkel is a Mapping the Landscape, Journeying Together grant recipient.
A Narrative Medicine curriculum was conducted at three obstetrics and gynecology training programs. Researchers examined the correlation between Narrative Medicine attendance and changes in pre- and 1-year-post tests. They found that burnout was high and worsened over time among obstetrics and gynecology residents in these three programs. Higher attendance at Narrative Medicine workshops was associated with improved Emotional Exhaustion.

Community health needs assessment as a teaching tool in a family medicine residency
Wilder V, Gagnon M, Olatunbosun B, Adedokun O, Blanas D, Arniella G, Maharaj-Best AC.
Fam Med. 2016 Sep;48(8):635-7.
Dr. Blanas is a Mapping the Landscape, Journeying Together grant recipient
A family medicine residency program in Harlem, NY conducted a Community Health Needs Assessment (CHNA), which offers an opportunity for residents to practice research and evaluation skills while learning about public health and the community they serve.  More than 50% of the residents surveyed reported that the CHNA greatly improved their comfort level speaking to patients about social factors that affect their health.

The September 2016 issue of Academic Medicine is focused on Fostering Student, Resident, and Faculty Wellness and includes several recommended articles. One is co-authored by Mapping the Landscape, Journeying Together grantees Tait Shanafelt and Lotte Dyrbye:  Burnout and alcohol abuse/dependence among U.S. medical students

Other Publications

Allocation of physician time in ambulatory practice: A time and motion study in 4 specialties
Sinsky C, Colligan L, Li L, Prgomet M, et al.    Ann Intern Med. 2016 Sep 6.  

Researchers analyzed a quantitative direct observational time and motion study (during office hours) and self-reported diary (after hours) of 58 US physicians in 4 specialties in 4 states. They found that for every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another 1 to 2 hours of personal time each night doing additional computer and other clerical work.

Communication during pediatric intensive care unit family conferences: A pilot study of content, communication, and parent perceptions
Michelson K, Clayman ML, Ryan C, Emanuel L, Frader J.    Health Commun. 2016 Sep 9:1-8

Researchers conducted a study of the focus of discussion and communication patterns of health care team members and parents, and parents’ perspectives about clinician communication during PICU family conferences.  Their findings suggest that while health care providers spend most of their time during family conferences relaying medical information, more attention should be directed at providing information in an understandable manner.

Predictors of satisfaction with doctor and nurse communication: A national study
McFarland DC, Shen MJ, Holcombe RF.    Health Commun. 2016 Sep 9:1-8.

Researchers examined county-level data including population density, population diversity, and hospital structural factors as predictors of patient satisfaction with doctor and nurse communication. County-level factors accounted for 30% and 16% of variability in patient satisfaction with doctor and nurse communication, respectively. College education and White ethnicity most strongly predicted a favorable rating of doctor and nurse communication, respectively. Non-English primary language most strongly predicted an unfavorable rating of doctor communication, while number of hospital beds and foreign-born most strongly predicted an unfavorable rating of nurse communication.

This post was written by Brandy King, Head of Information Services at The Arnold P. Gold Foundation Research Institute