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Lennon MJ, McGrail MR, O'Sullivan B, Tan A, Mok C, Suttie JJ, Preddy J. Understanding the professional satisfaction of hospital trainees in Australia. MEDICAL EDUCATION 2020; 54:419-426. [PMID: 31793665 DOI: 10.1111/medu.14041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/18/2019] [Accepted: 11/26/2019] [Indexed: 05/17/2023]
Abstract
CONTEXT Ensuring that specialty trainees are professionally satisfied is not only important from the point of view of trainee well-being, but is also critical if health systems are to retain doctors. Despite this, little systematic research in specialist trainees has identified policy-amenable factors correlated with professional satisfaction. This study examined factors associated with trainee professional satisfaction in a national Australian cohort. METHODS This study used 2008-2015 data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, a national study of doctor demographics, characteristics and professional and personal satisfaction. Our study examined specialist trainees using a repeat cross-sectional method pooling first responses across all waves. A multivariate logistic regression analysis was used to assess correlates with professional satisfaction. RESULTS The three factors most strongly correlated with professional satisfaction were feeling well supported and supervised by consultants (odds ratio [OR] 2.59, 95% confidence interval [CI] 2.42-2.77), having sufficient study time (OR 1.54, 95% CI 1.40-1.70) and self-rated health status (OR 1.65, 95% CI 1.53-1.80). Those working >56 hours per week were significantly less professionally satisfied (OR 0.76, 95% CI 0.70-0.84) compared with those working the median work hours (45-50 hours per week). Those earning in the lower quintiles, those earlier in their training and those who had studied at overseas universities were also significantly less likely to be satisfied. CONCLUSIONS Our study suggests that good clinical supervision and support, appropriate working hours and supported study time directly impact trainee satisfaction, potentially affecting the quality of clinical care delivered by trainees. Furthermore, the needs of junior trainees, overseas graduates and those working >56 hours per week should be given particular consideration when developing well-being and training programmes.
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Affiliation(s)
- Matthew J Lennon
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
| | - Matthew R McGrail
- Rural Clinical School, University of Queensland, Rockhampton, Queensland, Australia
| | - Belinda O'Sullivan
- Rural Clinical School, University of Queensland, Rockhampton, Queensland, Australia
- Monash University School of Rural Health, Bendigo, Victoria, Australia
| | - Amelia Tan
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
| | - Claire Mok
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
| | - Joseph J Suttie
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
- Wagga Wagga Clinical School, Notre Dame University, Wagga Wagga, New South Wales, Australia
| | - John Preddy
- Rural Clinical School, University of New South Wales, Wagga Wagga, New South Wales, Australia
- New South Wales Department of Health, Murrumbidgee Local Health District, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
- Wagga Wagga Clinical School, Notre Dame University, Wagga Wagga, New South Wales, Australia
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Pattin AJ, Devore N, Fowler J, Weldy D. An Examination of the Prescription Renewal Process and Implications for Primary Care Physicians and Community Pharmacists. J Pharm Pract 2018; 33:187-191. [PMID: 30222033 DOI: 10.1177/0897190018799217] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In physician practices and pharmacies, staff members work to process prescription renewals so that patients receive a steady supply of medications. These functions are essential to ensure patients have continuous access to medications and remain adherent to prescribed therapies. Despite the incorporation of e-prescribing software programs to ease management of these processes, barriers to effective management of the prescription renewal process exist. Mismanagement of pharmacy adherence programs can ultimately lead to patients receiving inappropriate medications and excessive use of staff resources. The objective of this article is to examine the prescription renewal process in both the primary care setting and the pharmacy and report challenges associated with the process. A literature review was conducted to find studies that describe pharmacists' and physicians' handlings of prescription renewals, use of e-prescribing software, and benefits and barriers to using these technologies. Although studies report e-prescribing software improves efficiency in the prescription renewal process, there is a need to reduce technological problems that create challenges in use. It is recommended that staff within physician practices and pharmacies standardize prescription renewal processes and educate patients about the prescription renewal process.
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Affiliation(s)
- Anthony J Pattin
- Department of Pharmacy Practice, College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, OH, USA
| | - Nathan Devore
- College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | | | - David Weldy
- Department of Family Medicine, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
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Sarchielli G, De Plato G, Cavalli M, Albertini S, Nonni I, Bencivenni L, Montali A, Ventura A, Montali F. Is medical perspective on clinical governance practices associated with clinical units' performance and mortality? A cross-sectional study through a record-linkage procedure. SAGE Open Med 2016; 4:2050312116660115. [PMID: 27504183 PMCID: PMC4962520 DOI: 10.1177/2050312116660115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/19/2016] [Indexed: 11/15/2022] Open
Abstract
Objective: Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units’ performance measured through mortality rates and efficiency indicators. Methods: This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians) working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors’ knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units’ performance indicators which include patients’ mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators. Results: The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units’ efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility). These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units’ mortality rates (odds ratio, −8.677; 95% confidence interval, −16.654, −0.700). Conclusion: The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful the clinical governance tools application on its own clinical practice.
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Affiliation(s)
| | | | - Mario Cavalli
- University Hospital St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | | | - Ilaria Nonni
- University Hospital St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | | | - Arianna Montali
- University Hospital St. Orsola-Malpighi Polyclinic, Bologna, Italy
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Henderson J, Valenti LA, Britt HC, Bayram C, Wong C, Harrison C, Pollack AJ, Gordon J, Miller GC. Estimating non-billable time in Australian general practice. Med J Aust 2016; 205:79-83. [PMID: 27456449 DOI: 10.5694/mja16.00287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 05/12/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To quantify the time that general practitioners spend on patient care that is not claimable from Medicare (non-billable) and the monetary value of this work were it claimable, and to identify variables independently associated with non-billable time. DESIGN Prospective, cross-sectional survey, April 2012 - March 2014. SETTING Australian general practice; a substudy of the national Bettering the Evaluation and Care of Health (BEACH) program. PARTICIPANTS 1935 randomly sampled GPs (77.4% participation rate) from across Australia provided filled questionnaires on 66 458 patient encounters. MAIN OUTCOME MEASURES Non-billable time spent on patient care since patient's previous consultation; duration of and reasons for non-billable time; estimate of its monetary value were it claimable from Medicare; variables associated with non-billable time. RESULTS 69.5% of GPs reported non-billable care outside patient visits; 8019 patient encounters (12.1%) were associated with an occasion of non-billable time. Mean time spent per occasion was 10.1 min (range, 1-240 min). Reasons for non-billable time included arranging tests and referrals, consulting specialists or allied health professionals, medication renewals, and advice and education, and encompassed all International Classification of Primary Care Version 2 chapters. The notional average annual value per GP of this work was $10 525.95 (level A rebate) to $23 008.05 (level B). Non-billable time was independently associated with female GPs, younger GPs (under 55 years), female patients, patients aged 65 years or more, and one or more chronic problems being managed at the recorded encounter. CONCLUSION Most GPs spend a significant amount of unpaid time on patient care between consultations, an inherent problem of the fee-for-service system. This work should inform discussions of future funding models.
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Affiliation(s)
- Joan Henderson
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | - Lisa A Valenti
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | - Helena C Britt
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | - Clare Bayram
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | - Carmen Wong
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | - Christopher Harrison
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | - Allan J Pollack
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | - Julie Gordon
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
| | - Graeme C Miller
- All the authors are from Family Medicine Research Centre, University of Sydney, Sydney, NSW
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