Building a Culture of Support at a Pediatric Surgery Center Through Multidisciplinary Peer Support.
Building a Culture of Support at a Pediatric Surgery Center Through Multidisciplinary Peer Support.
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通过多学科同伴支持在小儿外科中心建立支持文化。
DOI：
10.1016/j.jss.2023.04.029
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Wieck,Minna
中科院分区：
文献类型：
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作者：
Doyle,Kathleen;Murray,Trudee;Fong,IanC;Chavez,Angela;Rounds,Ginger;Linenberger,Michelle;Wieck,Minna
外科医生和围手术期工作人员的职业倦怠率很高，表现为疲劳、人格解体和缺乏成就感。后果包括错误和患者不良事件的增加。关于多学科同伴支持系统在对抗倦怠方面的有效性的数据很少。我们设法建立一支经过正式训练的多学科同侪支援队伍，以提高员工士气。方法自行选择的外科医生、麻醉师和护士作为机构同伴支持计划的一部分接受了正式的同伴反应者培训。我们儿科外科中心的所有围手术期工作人员（n= 120）在项目开始前进行调查，然后在项目开始后1个月和12个月进行调查。主要结果是单位士气、单位支持和同伴可接近性。各调查间和各位置间的主要结果比较采用Kruskal-Wallis检验和卡方检验，α值为0.05表示显著性。机构审查委员会的批准被放弃。结果调查应答率按时间顺序分别为57.5%、32.5%和37.5%。1年后，单位支持（P< 0.01）和同伴可接近性（P< 0.001）有统计学意义的增加，单位士气（P= 0.22）无统计学意义的增加。在按工作人员角色进行的亚组分析中，外科医生最不可能利用同伴支持。结论多学科同伴支持团队是建立围手术期支持文化、提高围手术期员工士气的有效且易于复制的方法。外科医生寻求跨专业同伴支持的可能性最小。因此，可能需要针对外科医生的策略。正在进一步调查对工作人员倦怠率、患者安全和护理质量的继发影响。
IntroductionSurgeons and perioperative staff experience high rates of burnout manifesting as exhaustion, depersonalization, and lack of achievement. Consequences include increases in errors and adverse patient events. Little data exist regarding the effectiveness of multidisciplinary peer support systems in combatting burnout. We sought to improve staff morale through establishment of a formally trained, multidisciplinary peer support team.MethodsSelfselected surgeons, anesthesiologists, and nurses were formally trained as Peer Responders as part of an institutional peer support program. All perioperative staff at our pediatric surgery center (n= 120) were surveyed before initiation of the program and then 1-mo and 12-mo after initiation. Primary outcomes were unit morale, unit support, and peer approachability. Kruskal–Wallis tests and Chi-squared tests were used for comparison of primary outcomes among surveys and by position with an alpha value of 0.05 set for significance. Institutional review board approval was waived.ResultsThe survey response rates were 57.5%, 32.5%, and 37.5% chronologically. After 1 year, there were statistically significant increases in unit support (P< 0.01) and peer approachability (P< 0.001), and a nonstatistically significant increase in unit morale (P= 0.22). On subgroup analysis by staff role, surgeons were least likely to utilize peer support.ConclusionsA multidisciplinary peer support team is an effective and easily reproducible means of building a culture of support and improving morale among perioperative staff. Surgeons were least likely to seek interprofessional peer support. Consequently, surgeon-specific strategies may be necessary. Further investigations are ongoing regarding secondary effects on staff burnout rates, patient safety, and quality of care.