UPJ INSIGHT: Promoting Organizational Change: A Urology Department-wide Wellness Program to Reduce Burnout

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UPJ INSIGHT: Promoting Organizational Change: A Urology Department-wide Wellness Program to Reduce Burnout

By: Ezra J. Margolin, MD; Rashed L. Kosber, MD; Michael B. Smigelski, MD; Saba Rawjani, MBA, MPH; Sanny Deleon, BA; Salimah Velji, MBA, MPH; Edwin Melendez, MBA; Christopher B. Anderson, MD, MPH; James M. McKiernan, MD; Gina M. Badalato, MD | Posted on: 01 Dec 2022

Margolin EJ, Kosber RL, Smigelski MB, et al. Promoting organizational change: a urology department-wide wellness program to reduce burnout. Urol Pract. 2022;9(6):614-622.

Study Need and Importance

Urologists have high rates of burnout, and little is known about burnout among nonphysician staff in urology departments. To address burnout in our department, we designed and implemented a department-wide wellness initiative across all role groups with specific interventions targeted at faculty, residents, nurses, administrators, coordinators, and other departmental personnel. Our wellness initiative was implemented October 2020. It included programs for the whole department (holiday-themed gatherings, pizza lunches, employee recognition events, and a virtual networking board), programs for residents (financial education workshops, weekly lunches, peer support sessions, and exercise equipment), programs for faculty (personal wellness days), and programs for nonphysician staff (weekly lunches and professional development sessions).

What We Found

From the pre-intervention survey to the post-intervention survey, burnout scores in the department improved significantly. There was also a significant improvement in respondents’ sense of community. When adjusting for role group and gender, there was improvement in burnout, sense of community, and professional fulfillment (based on the Stanford Professional Fulfillment Index; see Table). The most highly rated components of the wellness initiative were holiday-themed gatherings, weekly lunches, and employee of the month recognition.

Limitations

This study was limited by non-linking of pre- and post-intervention surveys, short duration of study period, recall and response biases, inability to control for external factors that may have an impact on wellness, and unclear external generalizability.

Table. Ordinal Logistic Regression Models of the Association Between Study Outcomes and Completion of the Wellness Curriculum

Outcome	OR	95% CI	P value
Burnout (n=114)	0.44	0.21-0.90	.025
Professional fulfillment (n=109)	2.05	1.04-4.05	.038
Work exhaustion (n=109)	0.62	0.32-1.21	.162
Interpersonal disengagement (n=109)	0.63	0.32-1.24	.182
Sense of community (n=114)	3.97	1.86-8.47	< .001
Abbreviations: CI, confidence interval; OR, odds ratio. Each outcome was evaluated in a separate model. Each model is adjusted for role group (nonclinical staff, clinical staff, physician) and gender. OR represents the odds of a categorical increase in the outcome with completion of the wellness curriculum. N=114 (5 participants were excluded due to unknown gender).

Interpretation for Patient Care

A department-wide wellness initiative with interventions targeted at different role groups can help reduce burnout, improve professional fulfillment, and cultivate workplace community. Such a program has the potential to improve patient care, workplace culture, and employee retention.