Looking Across the Drape: A Novel Quality Improvement Approach to Understanding Surgeon and Anesthesiologist Burnout

Jina L Sinskey; Rachel Schwartz; Christy K Boscardin; Joyce M Chang; Sandhya B Kumar; Carter C Lebares

doi:10.1097/SLA.0000000000006241

Looking Across the Drape: A Novel Quality Improvement Approach to Understanding Surgeon and Anesthesiologist Burnout

Ann Surg. 2024 Feb 20. doi: 10.1097/SLA.0000000000006241. Online ahead of print.

Authors

Jina L Sinskey¹, Rachel Schwartz¹, Christy K Boscardin^{1

2}, Joyce M Chang¹, Sandhya B Kumar³, Carter C Lebares³

Affiliations

¹ Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA.
² Department of Medicine, University of California, San Francisco, San Francisco, CA.
³ Department of Surgery, University of California, San Francisco, San Francisco, CA.

PMID: 38375660
DOI: 10.1097/SLA.0000000000006241

Abstract

Objective: To identify well-being threats for surgeons and anesthesiologists and develop interventions using the Quality of Life Improvement (QOLI) approach.

Background: Developing feasible perioperative well-being interventions requires identifying shared and specialty-specific well-being needs. The QOLI framework integrates human-centered design, implementation science, and quality improvement to address well-being needs.

Methods: Anesthesia and surgery faculty in eight perioperative departments at an academic medical center completed cross-sectional surveys containing validated measures of well-being and workplace satisfaction, and open-ended questions about professional motivations, pain points, strategies for improvement, and well-being priorities. Using template analysis, we analyzed open-ended survey data and presented resulting themes at a joint-specialty town hall for live-voting to identify well-being priorities.

Results: 104 perioperative faculty completed the survey. Across specialties, higher MHC-SF scores (representative of individual global well-being) were associated with higher satisfaction with workplace control, values, decision latitude, and social support. Anesthesiologists reported lower satisfaction and control than surgeons across multiple domains. Template analysis yielded five areas for intervention: (1) Work culture, (2) Work environment/resources, (3) Sources of fulfillment, (4) Work/life harmony, (5) Financial compensation. Surgeons and anesthesiologists both prioritized high-quality patient care but differed in their other top priorities. The most frequently cited well-being threats for surgeons were OR inefficiencies/delays and excessive workload, while anesthesiologists cited understaffing and unpredictable work hours.

Conclusions: Surgeons and anesthesiologists share many needs and priorities, with pain points that are often negatively synergistic. Applying the QOLI approach across specialties allows for well-being interventions that honor complexity and promote the development of feasible solutions.