Clinician Burnout and Social Determinants

December 17, 2021 updated by: Wake Forest University Health Sciences

Addressing Social Determinants of Health to Reduce Physician Burnout

Although clinicians recognize the impact of the social determinants of health (SDH) on patient care, clinicians feel they do not have the time or knowledge to effectively address patients' unmet social needs in the clinic. This can lead to feelings of distress and helplessness. The objective of this study is to test the impact of a tablet-based platform that enhances the role of support staff to address SDH on clinician burnout.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Clinician burnout has risen over the last decade, and studies have found that almost 50% of U.S. physicians show signs of burnout. Burnout is characterized by emotional exhaustion, feelings of cynicism, and patient detachment. Clinicians at the front lines of care, such as family medicine and internal medicine, are at highest risk, and burnout is associated with an increased risk of cardiovascular disease, alcoholism, and suicide. Burnout also negatively impacts patient care. The drivers of burnout are complex, and a growing body of research has focused on developing strategies to address both clinician and organizational factors. One potential contributor to clinician burnout that has received less attention is their patients' SDH.

The SDH, or the circumstances in which people are born, grow, live, and age, have a profound impact on morbidity and mortality. Increasingly, national organizations have called for healthcare systems to address SDH, such as food and housing insecurity, to improve population health. Although clinicians recognize the importance of SDH on patient care, clinicians feel they do not have the time, knowledge, or tools to effectively address SDH, which can leading to feelings of distress and helplessness in addressing patients' unmet social needs. The SDH can lead to increased patient complexity and clinician workload. Also, the seemingly insurmountable social needs faced by many patients are a major contributor to the decline in medicine residents choosing a career in primary care. Thus, the lack of a tool to assist the primary care team in addressing SDH is a critical problem that can negatively affect both patients and clinicians.

Our long-term goal is to enhance the primary care teams' ability to address the SDH by utilizing a mobile health tool that can assist the team in addressing patients' unmet social needs in clinical settings. Mobile health tools, such as tablets, have shown promise in reducing disparities in care and addressing unmet social needs in pediatric practices. However, there is little data about how addressing SDH affects physician burnout. Mobile health tools have the potential to collect patient-reported data and connect patients to appropriate support personnel without interfering with clinic workflow and enhance the primary care teams' ability to provide patients with resources. The objective of this study is to test the impact of a tablet-based platform that enhances the role of support staff to address SDH on clinician burnout.

Study Type

Interventional

Enrollment (Actual)

34

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • North Carolina
      • Winston-Salem, North Carolina, United States, 27101
        • Wake Forest Downtown Health Plaza (DHP)
      • Winston-Salem, North Carolina, United States, 27104
        • Family Medicine-Piedmont Plaza
      • Winston-Salem, North Carolina, United States, 27157
        • Internal Medicine-Janeway Tower

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • All clinicians and primary care teams at participating sites will be eligible

Exclusion Criteria:

  • There are no specific exclusion criteria

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention sites-Tablet-based SDH tool
All clinicians and primary care teams at a practice that are randomized to the intervention will receive the tablet-based SDH tool.
Other: Tablet-based SDH tool
A tablet-based SDH tool, which integrates responses into the EpicCare electronic health record (EHR).
No Intervention: Control sites
Care as usual, no tablet-based SDH tool.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mini-Z Scale
Time Frame: Baseline
This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome.
Baseline
Mini-Z Scale
Time Frame: 6 month post baseline
This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome.
6 month post baseline
Mini-Z Scale
Time Frame: 12 month post baseline
This scales measures clinician satisfaction. Total score 10 to 45. Higher scores denotes better outcome.
12 month post baseline

Secondary Outcome Measures

Outcome Measure
Time Frame
The number of clinicians who report a joyful workplace
Time Frame: Baseline
Baseline
The number of clinicians who report a joyful workplace
Time Frame: 6 months post baseline
6 months post baseline
The number of clinicians who report a joyful workplace
Time Frame: 12 months post baseline
12 months post baseline
The number of clinicians who report a supportive practice
Time Frame: Baseline
Baseline
The number of clinicians who report a supportive practice
Time Frame: 6 months post baseline
6 months post baseline
The number of clinicians who report a supportive practice
Time Frame: 12 months post baseline
12 months post baseline
The number of clinicians who report a good work pace
Time Frame: Baseline
Baseline
The number of clinicians who report a good work pace
Time Frame: 6 months post baseline
6 months post baseline
The number of clinicians who report a good work pace
Time Frame: 12 months post baseline
12 months post baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Wake Forest University Health Sciences

Investigators

  • Principal Investigator: Deepak Palakshappa, MD, Wake Forest University Health Sciences

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 18, 2019

Primary Completion (Actual)

July 31, 2021

Study Completion (Actual)

October 29, 2021

Study Registration Dates

First Submitted

August 22, 2019

First Submitted That Met QC Criteria

August 23, 2019

First Posted (Actual)

August 28, 2019

Study Record Updates

Last Update Posted (Actual)

January 10, 2022

Last Update Submitted That Met QC Criteria

December 17, 2021

Last Verified

June 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB00059798
  • 1902014 (Other Grant/Funding Number: American Medical Association)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

All of the individual participant data collected during the trial, after deindentification

IPD Sharing Time Frame

Immediately following publication, no end date

IPD Sharing Access Criteria

Researchers who provide a methodologically sound proposal

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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