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AMEDD Center & School Dept of Preventive Health Services Soldier & Family Support Branch

AMEDD Center & School Dept of Preventive Health Services Soldier & Family Support Branch. Data Analyses on Provider Fatigue & Burnout in MEDCOM. MAJ Graeme Bicknell, PhD, LISW MAJ Sheila Adams, PhD, LCSW, BCD. 12 August 2009. UNCLASSIFIED/FOUO. BRIEFING OUTLINE. Brief History Methodology

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AMEDD Center & School Dept of Preventive Health Services Soldier & Family Support Branch

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  1. AMEDD Center & SchoolDept of Preventive Health Services Soldier & Family Support Branch Data Analyses on Provider Fatigue & Burnout in MEDCOM MAJ Graeme Bicknell, PhD, LISW MAJ Sheila Adams, PhD, LCSW, BCD 12 August 2009 UNCLASSIFIED/FOUO

  2. BRIEFING OUTLINE • Brief History • Methodology • MEDCOMProQOL Findings • Provider Resiliency Training www.googleimages.com UNCLASSIFIED/FOUO MAJ Bicknell (210) 221-6073 (DSN XXX) / graeme.bicknell@amedd.army.mil

  3. History • Walter Reed Incident 2007,MG Pollick’s assessment • SAMMC Institutional Review Board 30NOV07 • Mandated by FRAGO 34 (to Implementation of the Army Medical Action Plan) 27JUN08 • Data collection www.googleimages.com

  4. Methodology • Professional Quality of Life Scale (ProQOL) (Stamm, 2005) https://www.us.army.mil/suite/page/200013 • ProQOL • Demographics • Video training qualitative questions • “Protected” • Data maintained at Ft. Detrick, transferred to Soldier Family Support Branch, FSH, FEB09

  5. ProQOL • Compassion Satisfaction is about the pleasure you derive from being able to do your work well

  6. ProQOL Burn Out is associated with feelings of hopelessness and difficulties in dealing with work or in doing your job effectively.

  7. ProQOL Compassion Fatigue is about your work-related secondary exposure to extremely stressful events.

  8. Demographics • General Demographics • Gender • Ethnicity • Age • Rank • MEDCOM Specific • Medical specialty • Medical treatment facility • Deployment history • Time in position www.googleimages.com

  9. What are we comparing to? All of us against them All of us against some of us Some of us against some others of us Us against the future us MEDCOM Population MEDCOM Population MEDCOM Sub-Samples MEDCOM Standard ProQOL Norming Sample MEDCOM Sub-Samples MEDCOM Sub-Samples

  10. Bottom Line • Overall MEDCOM has less Burn Out and Compassion Fatigue than the ProQOL norming population both statistically and substantively • Within MEDCOM Physicians report more Burn Out than MEDCOM Overall • Within MEDCOM, Enlisted Direct Care Respondents consistently reported having more Burn Out, Compassion Fatigue and less Compassion Satisfaction.

  11. Bottom Line • Within MEDCOM, Civilians consistently report less Burn Out, Compassion Fatigue and more Compassion Satisfaction. • Within MEDCOM Military Only, those who report having deployed report more Burn Out, Compassion Fatigue and less Compassion Satisfaction than MEDCOM overall.

  12. Population Versus MEDCOM Population Versus MEDCOM ONE SAMPLE T-TEST Burn Out t-Test -86.8, p<.001, Compassion Fatigue t-Test -70.83, p<.001 Compassion Satisfaction t-Test 29.26, p<.001, CAUTION: MEDCOM RESPONDENTS RECEIVED A 20 MINUTE “PROVIDER RESILENCY TRAINING” INTERVENTION PRIOR TO TAKING THE PROQOL. THE PROQOL NORMING POPULATION DID NOT RECEIVE ANY TRAINING PRIOR TO RESPONDING TO THE SURVEY

  13. Population Versus MEDCOM Chi Square Tests between MEDCOM Observed Frequencies and ProQOL Expected Frequencies: Burn Out Chi-Square 4002.587 p<.001, Compassion Fatigue Chi-Square 18258.1, p<.001, Compassion Satisfaction Chi-Square 6670.19, p<.001

  14. MEDCOM Demographics Note: Percentages less than 1 not graphically displayed

  15. MEDCOM Respondents by Specialty ** Burn Out * ** ** Compassion Fatigue ** ** ** Compassion Satisfaction ** ** ** ** Chi Square Tests between Specialty Observed Frequencies and MEDCOM (mean) Expected Frequencies by ProQOL construct: Burn Out 18%, Compassion Fatigue 14%, Compassion Satisfaction 24% * Denotes statistically significant difference from MEDCOM mean with a p value <.01 ** Denotes statistically significant difference from MEDCOM mean with a p value <.001 Slide 15 of 23

  16. MEDCOM Deployment Note: Percentages less than 1 not graphically displayed. There were no respondents deployed in the 37 to 48 month bracket.

  17. MEDCOM Versus MEDCOM Sub Samples Burn Out ** ** ** Compassion Fatigue ** ** Compassion Satisfaction ** ** ** Chi Square Tests between MEDCOM All Observed Frequencies and ProQOL Expected Frequencies: Burn Out Chi-Square 4002.587 p<.001, Compassion Fatigue Chi-Square 18258.1, p<.001, Compassion Satisfaction Chi-Square 6670.19, p<.001 Chi Square Tests between MEDCOM Sub Samples Observed Frequencies and MEDCOM ALL Expected Frequencies by ProQOL construct: Burn Out 18%, Compassion Fatigue 14%, Compassion Satisfaction 24% ** Denotes statistically significant difference from MEDCOM mean with a p value <.001 Slide 17 of 23

  18. Cautions • Social desirability bias. • Assumption of 1 in 4. • Use of cutoff scores. • Size of the dataset, www.googleimages.com

  19. AMEDD C&S Training Opportunities • Train the Trainer Course • Regional Medical Command (RMC)/MTF PR Trainers/Leaders • Guidance on developing, implementing and sustaining an organizational Commander PR program at the RMC/MTF level, • Understanding research • Key concepts and theories • Resiliency building skills/practices using effective intervention training strategies

  20. AMEDD C&S Training Opportunities • The Professional Resiliency Resident Course • Targets professional medical staff i.e. Doctors, Nurses, Ancillary Staff GS11 & above and E7 & above • Focuses on the most advanced research, concepts, and theories as it relates to self care management. • Attendees will have the opportunity to participate in various experiential learning self-help techniques. Using personal introspection, participants will focus on internal and external stressors that contribute to burnout and compassion fatigue. • The PRT also conducts Mobile Training as requested.

  21. Questions?????

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