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Zbyrak V, Radwan RM, Salgado TM, Dixon DL, Sisson EM, Pamulapati LG. Job satisfaction among board-certified pharmacists in Virginia. J Am Pharm Assoc (2003) 2024; 64:126-132. [PMID: 37774836 DOI: 10.1016/j.japh.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/01/2023] [Accepted: 09/22/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Board certification has been associated with job satisfaction. Identifying factors influencing board-certified pharmacists' job satisfaction can assist employers in recruitment and retention. OBJECTIVES To identify factors associated with job satisfaction among board-certified pharmacists in Virginia. METHODS This cross-sectional study utilized data from the 2018 Virginia Pharmacy Workforce Survey and included pharmacists who held an active license in Virginia, were employed within the last year, and held any Board of Pharmacy Specialties certification. Descriptive statistics were used to summarize the data, and bivariate analyses compared job satisfaction across demographics and practice characteristics. Multivariable logistic regression identified factors associated with job satisfaction. RESULTS Of 15,424 licensed pharmacists, 13,962 completed the survey (90.5%), while 1,284 (9.2%) met the inclusion criteria. Respondents were primarily female (69.4%) with a mean (SD) of 10.5 (9.6) years of work experience. Pharmacists predominantly held one full-time position (81.5%), earned an annual income between $100,000-$149,999 (77.0%), and worked in inpatient health systems (43.9%). Most board-certified pharmacists (93.7%) reported being very/somewhat satisfied with their current job. Job satisfaction was associated with work setting, primary hours worked per week, and paid sick leave benefits in bivariate analyses. In the multivariable logistic regression model, pharmacists working 30-49 versus ≥50 h/wk in their primary job (aOR= 2.91, 95% CI 1.63, 5.20), earning ≥$150,000 versus $100,000-$149,999 (aOR=4.60, 95% CI 1.21, 17.46), and with paid sick leave benefits (aOR= 1.92, 95% CI 1.19, 3.10) were more likely to report higher job satisfaction. Additionally, working in academia (aOR= 5.36, 95% CI 1.45, 19.85), inpatient health system (aOR= 3.13, 95% CI 1.41, 6.94), and outpatient health system (aOR= 4.07, 95% CI 1.33, 12.51) were associated with job satisfaction. CONCLUSION Board-certified pharmacists in Virginia reported high job satisfaction. Primary hours worked per week, income, paid sick leave, and work setting were positively associated with job satisfaction.
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Rotea CC, Ploscaru AN, Bocean CG, Vărzaru AA, Mangra MG, Mangra GI. The Link between HRM Practices and Performance in Healthcare: The Mediating Role of the Organizational Change Process. Healthcare (Basel) 2023; 11:healthcare11091236. [PMID: 37174777 PMCID: PMC10178150 DOI: 10.3390/healthcare11091236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
The role of human resources as a change agent in the organizational change process holds great importance. Hence, it is crucial to identify ways human resources can support change. This paper investigates the direct and indirect relationships between human resource management (HRM) practices and organizational performance, as well as the mediating role of the organizational change process in these relationships. The proposed model integrates primary HRM practices, organizational change components, organizational performance, employee retention, and organizational abandonment. We collected data to evaluate the relationships between the model variables through a survey questionnaire applied to 441 Romanian employees in the healthcare industry. The paper used structural equation modeling to test the model's validity and hypotheses. The results show that HRM practices directly impact organizational performance and have a mediated impact through the organizational change process. Additionally, the direct and mediating effects are consistent, and healthcare employers consider appropriate HRM practices and effective management of the organizational change process as essential drivers to achieve superior performance. The empirical findings provide valuable insights for government policymakers, stakeholders, and health managers on how suitable HRM practices can influence organizational performance.
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Affiliation(s)
| | | | - Claudiu George Bocean
- Department of Management, Marketing and Business Administration, Faculty of Economics and Business Administration, University of Craiova, 13 AI Cuza Street, 200585 Craiova, Romania
| | - Anca Antoaneta Vărzaru
- Department of Economics, Accounting and International Business, Faculty of Economics and Business Administration, University of Craiova, 13 AI Cuza Street, 200585 Craiova, Romania
| | - Mădălina Giorgiana Mangra
- Department of Finance, Banking and Economic Analysis, University of Craiova, 200585 Craiova, Romania
| | - Gabriel Ioan Mangra
- Department of Theory and Methodology of Motor Activities, University of Craiova, 200585 Craiova, Romania
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Leadership and Turnover Intentions in a Public Hospital: The Mediating Effect of Organisational Commitment and Moderating Effect by Activity Department. ADMINISTRATIVE SCIENCES 2023. [DOI: 10.3390/admsci13010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This research aimed to study the effect of leadership (transformational and transactional) on turnover intentions and whether this relationship is mediated by organisational commitment and moderated by the department of activity. To this end, it was hypothesized that: (1) leadership has a negative and significant association with turnover intentions; (2) leadership has a positive and significant association with affective organisational commitment; (3) organisational commitment has a negative and significant association with turnover intentions; (4) organisational commitment has a mediating effect on the relationship between leadership and turnover intentions; (5) the department to which the employee belongs has a moderating effect on the relationship between leadership and organisational turnover intentions. The sample consists of 477 participants working at the Hospital Professor Doutor Fernando Fonseca (HFF) in Portugal, performing their functions in several departments. This is a quantitative, correlational, and cross-sectional study. The results indicate that transformational leadership has a negative and significant effect on turnover intentions and a positive and significant effect on affective and normative commitment. Transactional leadership negatively and significantly affects all three components of organisational commitment. Affective and normative commitment has a negative and significant effect on turnover intentions. Calculative commitment has a positive and significant effect on turnover intentions. Affective commitment and calculative commitment have a partial mediating effect on the relationship between transformational leadership and organisational turnover intentions. The department to which the employee belongs does not have a moderating effect on the relationship between leadership and turnover intentions. It has been proven that leadership plays an extremely important role in the smooth running of this hospital unit.
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L’effet du sens du travail sur l’intention de quitter des personnels soignants en EHPAD. Quel impact de la satisfaction au travail et de la charge de travail ? PSYCHOLOGIE DU TRAVAIL ET DES ORGANISATIONS 2022. [DOI: 10.1016/j.pto.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Knudsen HK, Brown R, Jacobson N, Horst J, Kim JS, Kim H, Madden LM, Haram E, Molfenter T. Prescribers' satisfaction with delivering medications for opioid use disorder. Subst Abuse Treat Prev Policy 2021; 16:78. [PMID: 34663379 PMCID: PMC8521499 DOI: 10.1186/s13011-021-00413-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Expanding access to medications for opioid use disorder (MOUD), such as buprenorphine and extended release (XR) naltrexone, is critical to addressing the US opioid epidemic, but little is known about prescriber satisfaction with delivering these two types of MOUD. The current study describes the satisfaction of prescribers delivering buprenorphine and XR-naltrexone while examining whether satisfaction is associated with current patient census and organizational environment. METHODS As part of a cluster randomized clinical trial (RCT) focused on expanding access to medication for opioid use disorder, 41 MOUD prescribers in Florida, Ohio, and Wisconsin completed a web-based survey. The survey included measures of prescriber satisfaction with delivering buprenorphine treatment and XR-naltrexone. In addition, the survey measured several prescriber characteristics and their perceptions of the organizational environment. RESULTS Prescribers were generally satisfied with their work in delivering these two types of MOUD. Prescribers reporting a greater number of patients (r = .46, p = .006), those who would recommend the center to others (r = .56, p < .001), and those reporting positive relationships with staff (r = .56, p < .001) reported significantly greater overall satisfaction with delivering buprenorphine treatment. Prescribers who more strongly endorsed feeling overburdened reported lower overall buprenorphine satisfaction (r = -.37, p = .02). None of the prescriber characteristics or perceptions of the organizational environment were significantly associated with overall satisfaction with delivering XR-naltrexone treatment. CONCLUSIONS The generally high levels of satisfaction with both types of MOUD is notable given that prescriber dissatisfaction can lead to turnover and impact intentions to leave the profession. Future research should continue to explore the prescriber characteristics and organizational factors associated with satisfaction in providing different types of MOUD. REGISTRATION ClinicalTrials.gov. NCT02926482. Date of registration: September 9, 2016. https://clinicaltrials.gov/ct2/show/NCT02926482 .
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Affiliation(s)
- Hannah K. Knudsen
- Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Ave., Room 204, KY 40508 Lexington, USA
| | - Randy Brown
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, 1100 Delaplaine Ct, WI 53715-1896 Madison, USA
| | - Nora Jacobson
- Institute for Clinical and Translational Research, University of Wisconsin-Madison, 4116 Signe Skott Cooper Hall, 701 Highland Ave, WI 53705 Madison, USA
| | - Julie Horst
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, 1513 University Ave, WI 53706 Madison, USA
| | - Jee-Seon Kim
- Department of Educational Psychology, University of Wisconsin-Madison, 1025 West Johnson St, WI 53706-1706 Madison, USA
| | - Hanna Kim
- Department of Educational Psychology, University of Wisconsin-Madison, 1025 West Johnson St, WI 53706-1706 Madison, USA
| | - Lynn M. Madden
- Department of Internal Medicine, Yale University, APT Foundation, 1 Long Wharf Drive, Suite 321, CT 06511 New Haven, USA
| | - Eric Haram
- Haram Consulting, 413 River Road, ME 04008 Bowdoinham, USA
| | - Todd Molfenter
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, 1513 University Ave, WI 53706 Madison, USA
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Measures of Organizational Culture and Climate in Primary Care: a Systematic Review. J Gen Intern Med 2021; 36:487-499. [PMID: 33140272 PMCID: PMC7878641 DOI: 10.1007/s11606-020-06262-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Primary care is increasingly contributing to improving the quality of patient care. This has imposed significant demands on clinicians with rising needs and limited resources. Organizational culture and climate have been found to be crucial in improving workforce well-being and hence quality of care. The objectives of this study are to identify organizational culture and climate measures used in primary care from 2008 to 2019 and evaluate their psychometric properties. METHODS Data sources include PubMed, PsycINFO, HAPI, CINAHL, and Mental Measurements Yearbook. Bibliographies of relevant articles were reviewed and a cited reference search in Scopus was performed. Eligibility criteria include primary health care professionals, primary care settings, and use of measures representing the general concept of organizational culture and climate. Consensus-Based Standards for the selection of health Measurement Instruments (COSMIN) guidelines were followed to evaluate individual studies for methodological quality, rate results of measurement properties, qualitatively pool studies by measure, and grade evidence. RESULTS Of 1745 initial studies, 42 studies met key study inclusion criteria, with 27 measures available for review (16 for organizational culture, 11 for organizational climate). There was considerable variability in measures, both conceptually and in psychometric quality. Many reported limited or no psychometric information. DISCUSSION Notable measures selected for frequent use and strength and applicability of measurement properties include the Culture Questionnaire adapted for health care settings, Practice Culture Assessment, and Medical Group Practice Culture Assessment for organizational culture. Notable climate measures include the Nurse Practitioner Primary Care Organizational Climate Questionnaire, Practice Climate Survey, and Task and Relational Climate Scale. This synthesis and appraisal of organizational culture and climate measures can help investigators make informed decisions in choosing a measure or deciding to develop a new one. In terms of limitations, ratings should be considered conservative due to adaptations of the COSMIN protocol for clinician populations. PROSPERO REGISTRATION NUMBER CRD 42019133117.
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Baron AN, Hemler JR, Sweeney SM, Tate Woodson T, Cuthel A, Crabtree BF, Cohen DJ. Effects of Practice Turnover on Primary Care Quality Improvement Implementation. Am J Med Qual 2019; 35:16-22. [PMID: 31030525 PMCID: PMC6819201 DOI: 10.1177/1062860619844001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Primary care practices often engage in quality improvement (QI) in order to stay current and meet quality benchmarks, but the extent to which turnover affects practices' QI ability is not well described. The authors examined qualitative data from practice staff and external facilitators participating in a large-scale QI initiative to understand the relationship between turnover and QI efforts. The examination found turnover can limit practices' ability to engage in QI activities in various ways. When a staff member leaves, remaining staff often absorb additional responsibilities, and QI momentum slows as new staff are trained or existing staff are reengaged. Turnover alters staff dynamics and can create barriers to constructive working relationships and team building. When key practice members leave, they can take with them institutional memory about QI purpose, processes, and long-term vision. Understanding how turnover affects QI may help practices, and those helping them with QI, manage the disruptive effects of turnover.
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Measuring Certified Registered Nurse Anesthetist Organizational Climate: Instrument Adaptation. J Nurs Meas 2017; 25:224-237. [PMID: 28789748 DOI: 10.1891/1061-3749.25.2.224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE No tool exists measuring certified registered nurse anesthetist (CRNA) organizational climate. The study's purpose is to adapt a validated tool to measure CRNA organizational climate. METHODS Content validity of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ) was established. Pilot testing was conducted to determine internal reliability consistency of the subscales. RESULTS Experts rated the tool as content valid. The subscales had high internal consistency reliability (with respective Cronbach's alphas): CRNA-Anesthesiologist Relations (.753), CRNA-Physician Relations (.833), CRNA-Administration Relations (.895), Independent Practice (.830), Support for CRNA Practice (.683), and Professional Visibility (.772). CONCLUSIONS Further refinement of the CRNA-OCQ is necessary. Measurement and assessment of CRNA organizational climate may produce evidence needed to improve provider and patient outcomes.
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Freed GL, McGuinness GA, Moran LM, Spera L, Althouse LA. New pediatricians: first jobs and future workplace goals. Pediatrics 2015; 135:701-6. [PMID: 25802355 DOI: 10.1542/peds.2014-3372] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Concern is often expressed about the satisfaction of new physicians and the potential match of their workplace goals with available positions. We studied the interface of desired professional activities with actual initial positions. METHODS Survey study of all general pediatricians taking the 2012 General Pediatrics Certifying Examination. RESULTS Of the 5210 who sat for the General Pediatrics Certifying Examination, 5163 (>99%) completed the survey. Of the total respondents, 45% self- identified as general pediatricians (N = 2327). Of those who completed training <2 years ago (N = 1365), most were currently engaged in clinical care (87%; N = 1190). The most important factor, cited most frequently by both men and women, in the choice of their first job was lifestyle and spousal or family considerations. Most (83%; N = 977) reported that the allocation of time for specific duties in their current position was consistent with their goals, with no differences between men and women. Most had no desire for inpatient activity. CONCLUSIONS Despite concerns about young general pediatricians being able to find positions that meet their career goals, most were in jobs that approximated their desired allocation of professional time and focus of clinical work.
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Affiliation(s)
- Gary L Freed
- Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan; and
| | | | - Lauren M Moran
- Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and
| | - Laura Spera
- Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, Department of Pediatrics and Communicable Diseases, and
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Poghosyan L, Nannini A, Stone PW, Smaldone A. Nurse practitioner organizational climate in primary care settings: implications for professional practice. J Prof Nurs 2015; 29:338-49. [PMID: 24267928 DOI: 10.1016/j.profnurs.2013.07.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Indexed: 10/26/2022]
Abstract
The expansion of the nurse practitioner (NP) workforce in primary care is key to meeting the increased demand for care. Organizational climates in primary care settings affect NP professional practice and the quality of care. This study investigated organizational climate and its domains affecting NP professional practice in primary care settings. A qualitative descriptive design, with purposive sampling, was used to recruit 16 NPs practicing in primary care settings in Massachusetts. An interview guide was developed and pretested with two NPs and in 1 group interview with 7 NPs. Data collection took place in spring of 2011. Individual interviews lasted from 30-70 minutes, were audio recorded, and transcribed. Data were analyzed using Atlas.ti 6.0 software by 3 researchers. Content analysis was applied. Three previously identified themes, NP-physician relations, independent practice and autonomy, and professional visibility, as well as two new themes, organizational support and resources and NP-administration relations emerged from the analyses. NPs reported collegial relations with physicians, challenges in establishing independent practice, suboptimal relationships with administration, and lack of support. NP contributions to patient care were invisible. Favorable organizational climates should be promoted to support the expanding of NP workforce in primary care and to optimize recruitment and retention efforts.
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Affiliation(s)
- Lusine Poghosyan
- Assistant Professor, Columbia University School of Nursing, New York, NY..
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Alidina S, Rosenthal MB, Schneider EC, Singer SJ, Friedberg MW. Practice environments and job satisfaction in patient-centered medical homes. Ann Fam Med 2014; 12:331-7. [PMID: 25024241 PMCID: PMC4096470 DOI: 10.1370/afm.1662] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We undertook a study to evaluate the effects of medical home transformation on job satisfaction in the primary care setting. METHODS We collected primary data from 20 primary care practices participating in medical home pilot projects in Rhode Island and Colorado from 2009 to 2011. We surveyed clinicians and staff about the quality of their practice environments (eg, office chaos, communication, difficulties in providing safe, high-quality care) and job satisfaction at baseline and 30 months, and about stress, burnout, and intention to leave at 30 months. We interviewed practice leaders about the impact of pilot project participation. We assessed longitudinal changes in the practice environment and job satisfaction and, in the final pilot year, examined cross-sectional associations between the practice environment and job satisfaction, stress, burnout, and intention to leave. RESULTS Between baseline and 30 months, job satisfaction improved in Rhode Island (P=.03) but not in Colorado. For both pilot projects, reported difficulties in providing safe, high-quality care decreased (P<.001), but emphasis on quality and the level of office chaos did not change significantly. In cross-sectional analyses, fewer difficulties in providing safe, high-quality care and more open communication were associated with greater job satisfaction. Greater office chaos and an emphasis on electronic information were associated with greater stress and burnout. CONCLUSIONS Medical home transformations that emphasize quality and open communication while minimizing office chaos may offer the best chances of improving job satisfaction.
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Affiliation(s)
| | | | - Eric C Schneider
- Harvard School of Public Health, Boston, Massachusetts RAND Corporation, Boston, Massachusetts Brigham and Women's Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
| | - Sara J Singer
- Harvard School of Public Health, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts Massachusetts General Hospital, Boston, Massachusetts
| | - Mark W Friedberg
- RAND Corporation, Boston, Massachusetts Brigham and Women's Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
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Zallman L, Tendulkar S, Bhuyia N, Dube B, Early S, Arredondo M, Puleo R, Sengupta N, Alsan B, Hacker K. Provider's perspectives on building research and quality improvement capacity in primary care: a strategy to improve workforce satisfaction. Clin Transl Sci 2013; 6:404-8. [PMID: 24127931 PMCID: PMC5350894 DOI: 10.1111/cts.12066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Safety-net populations are underrepresented in research and quality improvement (QI) studies despite the fact that safety-net providers are uniquely positioned to engage in translational research. This study aimed to understand the current level of interest in, experience with, predicted career satisfaction associated with, and barriers experienced in conducting research and QI among primary care providers (PCPs) at 18 safety-net practices in the Boston, Massachusetts area. METHODS The Harvard Catalyst Safety-net Infrastructure Initiative partnered with staff at a large academic public hospital system, including 15 primary care sites, to develop and administer an online survey. This survey was then adapted and administered at three other academically affiliated community health centers. RESULTS Of the 260 providers surveyed, 136 (52%) responded. Nearly 80% reported interest in conducting either QI projects or clinical research and 95% of them believed it would enhance their career satisfaction. However, 63% did not report prior experience or training in research or QI and 93% reported at least one barrier to engagement. CONCLUSION While supporting safety-net PCPs' engagement in research and/or QI may improve career satisfaction there are numerous barriers that must be addressed to achieve this goal.
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Affiliation(s)
- Leah Zallman
- Institute for Community HealthCambridgeMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Shalini Tendulkar
- Institute for Community HealthCambridgeMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Nazmim Bhuyia
- Institute for Community HealthCambridgeMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Blessing Dube
- Institute for Community HealthCambridgeMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Scott Early
- Lynn Community Health CenterLynnMassachusettsUSA
- Tufts University School of MedicineBostonMassachusettsUSA
| | | | - Rozanne Puleo
- Lynn Community Health CenterLynnMassachusettsUSA
- Tufts University School of MedicineBostonMassachusettsUSA
| | - Nandini Sengupta
- The Dimock CenterRoxburyMassachusettsUSA
- Beth Israel Deaconess Deaconess Medical CenterBostonMassachusettsUSA
| | - Burak Alsan
- Upham's Corner Health CenterDorcesterMassachusettsUSA
| | - Karen Hacker
- Institute for Community HealthCambridgeMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
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