Date of Award

Fall 2023

Project Type

Clinical Doctorate

Department

Nursing

Program or Major

DNP

Degree Name

Other

First Advisor

Dayle Sharp

Abstract

Background: Primary care providers employed by federally qualified health centers (FQHC) working with underserved populations experience high levels of burnout as patients are often medically complex, face healthcare disparities and societal stigmas. The aim of the project was to alleviate burnout and improve provider retention through introduction of organizational support measures. Participants involved were healthcare providers, as well as nurse management and senior leadership.

Methods: The quality improvement approach for this project utilized the Plan-Do-Study-Act (PDSA) cycle and a driver diagram to guide the selected interventions. Interventions were based on categories from Mayo’s Clinic’s Nine Organizational Strategies to Promote Engagement and Reduce Burnout. This project concentrated on three primary areas: leadership, workflow and administration, and collaboration. To gauge effectiveness of the interventions, a modified version of the Mini Z survey was administered to providers before the implementation of the interventions to establish baseline burnout within the organization. The same modified Mini Z survey was redistributed post-intervention featuring additional questions to assess the impact of the implemented strategies. Data focusing on the top three departure reasons were collected from providers who left the organization within the last two and a half years to identify recurring themes and patterns for a comprehensive understanding of factors influencing provider turnover.

Results: There was a notable reduction in job related stress as from 69% pre-intervention to 60% post-intervention. A significant improvement was identified in the time spent at home on the electronic medical record (EMR) from 93% of providers reporting an excessive or moderately high amount of time pre-intervention to 60% post-intervention. The likelihood of provider departure within the next two years remained consistent pre- and post-intervention at 33%. Commonly cited reasons for departure were deficiencies in communication from leadership, systemic challenges, and broader organizational issues.

Conclusions: The project did not directly result in improved provider retention or reduced burnout however, it provided a platform to analyze organizational shortcomings and initiate actions in these critical areas. This project serves as an initial step for organizations to explore more comprehensive strategies and implement measures aimed at enhancing provider satisfaction and well-being with the ultimate goal of retaining valuable providers.

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