ABSTRACT
Resilience and occupational health of healthcare workers have emerged as central to the sustainable functioning healthcare systems during the COVID-19 pandemic. However, the range of interventions used to address this challenge remains fragmented, resting on variable empirical evidence and highly variable outcomes. Surgical team burnout is a syndrome characterized by emotional exhaustion, depersonalization, depression, and a decreased sense of personal accomplishment caused by work-related stressors. Clinicians are at a unique increased risk for burnout as a result of immense stress throughout their training and careers, long work hours, delayed gratification, challenges with sustaining work and home balance, and challenges associated with patient care and harm prevention. Future endeavors need to provide meaningful solutions, both in providing resources and pathways for perioperative team members who are already burned out and, more importantly, teaching clinicians to respond more effectively to their environment to help mitigate burnout and mortal injury. Specific protocols to reduce burnout among surgical teams from the beginning of their training and throughout their professional careers are needed. This chapter offers a systematic overview and evaluation of the structure, effectiveness, and resources required for implementing a wellness program, and a better understanding of what does and does not work. Feedback from those participating in these programs can provide a significant amount of information and help surgical team members from all disciplines. The development and implementation of effective programs may help clinicians before the problem dramatically affects their lives and directly impacts patient care and outcomes.
ABSTRACT
GOALS: We aimed to develop and validate a patient-reported experience measure for gastrointestinal (GI) endoscopy, the Comprehensive Endoscopy Satisfaction Tool that captures relevant domains that influence the patient's experience and identify factors that shape satisfaction. BACKGROUND: Patient-reported experience measures are used to capture specific quality aspects of health care services. GI endoscopic services are high-volume services, and there is a lack of specific, validated instruments to capture various domains that shape the patients' experience with routine clinical endoscopic services. STUDY: After an environmental scan and structured literature review, focus groups with patients were conducted to identify relevant factors influencing the patient experience with GI endoscopic services. After an initial validation in 101 patients undergoing routine GI endoscopies, the instrument was tested in 7800 patients. In addition, the influence of sociodemographic factors on global satisfaction was explored. RESULTS: The final version included 26 specific items plus 4 global ratings for preprocedure, experience on day of procedure, postprocedure care, and infrastructure. In addition, a global rating of the overall experience was included. Patient satisfaction was significantly higher in older patients (P<0.001) but not influenced by gender, nationality, marital status, education, or employment status. Interestingly, during periods of coronavirus disease-19-related service interruptions, the Net Promoter Score was significantly reduced (P<0.0001) providing evidence for the responsiveness of the instrument. CONCLUSIONS: The Comprehensive Endoscopy Satisfaction Tool is a valid measure for the patient experience with the various components of endoscopic services, allows for the identification of domains that impact on the patient experience and is a practical tool to compare patient satisfaction over time and across facilities.