46 Beyond rounds: improving physician wellness on the gynoncology service through meaningful connection

Abstract

Objectives: Burnout in medicine is a growing crisis, and SGO has identified combatting burnout as a priority. The estimated prevalence of burnout is almost 90% among Gyn-Oncology fellows and 50% among Ob/Gyn residents. Most wellness initiatives focus on helping trainees find fulfillment outside of the hospital, and little has been done to help trainees find wellness in their work. Our quality improvement project seeks to improve the wellness of physician trainees on the Gyn-Oncology service, by returning them to their patients’ bedsides to engage in meaningful activities and develop connections that go “Beyond Rounds.” Methods: Each week the team identifies a patient they think would benefit from engaging in a meaningful activity, and a trainee to pair with them. If the patient elects to participate, the patient and trainee select an activity to do together. Trainees are guaranteed 90 minutes of protected time during normal work hours for the activity. Outcomes are measured using the Physician Fulfillment Index (PFI), which measures both professional fulfillment and burnout. The pre and post-survey is self-administered via a QR code, and includes the PFI and short answer questions. Our project has a specific focus on equity and inclusion, and prioritizes patients who face barriers to care due to their gender/sexuality, race/ethnicity, insurance status, immigration status, or primary language. Funding was provided through a grant from the ACGME's “Back-to-Bedside” Initiative. Results: In the first 6 weeks of the project, 4 trainees completed a meaningful activity. The project has been met with enthusiasm and has been rapidly integrated into the workflow of the Gyn-Oncology service. We anticipate at least 16 meaningful activities to have been completed by June 2023. Activities chosen included: drinking coffee outside, manicures, working on a puzzle, and looking at family photographs. All trainees felt that their time was adequately protected and agreed that the experience changed their perspective on the care our team provides. The intervention had a large positive effect on professional fulfilment and a moderate positive effect on burnout (Cohen's D; medium = 0.4, large = 0.8). Common themes of the short answer questions included: developing a fulfilling connection, gaining a better understanding of how cancer impacts patients as people, and recognizing the trust and gratitude our patients have for our team. Conclusions: Our quality improvement project demonstrates that creating protected time for physician trainees to return to their patients’ bedsides, has an immediate, positive, and measurable effect on professional fulfillment and burnout. The causes of burnout are complex and multifactorial, but helping physicians find wellness in their work is essential to combatting it.