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Item Associations of job demands and patient safety event involvement on burnout among a multidisciplinary group of pediatric hematology/oncology clinicians(Wiley, 2021-11) Dunn, Tyler J.; Terao, Michael A.; Blazin, Lindsay J.; Spraker-Perlman, Holly; Baker, Justin N.; Mandrell, Belinda; Sellers, Janet; McLaughlin Crabtree, Valerie; Hoffman, James M.; Burlison, Jonathan D.; Pediatrics, School of MedicineBACKGROUND: Workplace burnout can result in negative consequences for clinicians and patients. We assessed burnout prevalence and sources among pediatric hematology/oncology inpatient nurses, ambulatory nurses, physicians (MDs), and advanced practice providers (APPs) by evaluating effects of job demands and involvement in patient safety events (PSEs). METHODS: A cross-sectional survey (Maslach Burnout Inventory) measured emotional exhaustion, depersonalization, and reduced personal accomplishment. The National Aeronautics and Space Administration Task Load Index measured mental demand, physical demand, temporal demand, effort, and frustration. Relative weights analyses estimated the unique contributions of tasks and PSEs on burnout. Post hoc analyses evaluated open-response comments for burnout factors. RESULTS: Burnout prevalence was 33%, 20%, 34%, and 33% in inpatient nurses, ambulatory nurses, and MD, and APPs, respectively (N = 481, response rate 69%). Reduced personal accomplishment was significantly higher in inpatient nurses than MDs and APPs. Job frustration was the most significant predictor of burnout across all four cohorts. Other significant predictors of burnout included temporal demand (nursing groups and MDs), effort (inpatient nurses and MDs), and PSE involvement (ambulatory nurses). Open-response comments identified time constraints, lack of administrator support, insufficient institutional support for self-care, and inadequate staffing and/or turnover as sources of frustration. CONCLUSIONS: All four clinician groups reported substantial levels of burnout, and job demands predicted burnout. The body of knowledge on job stress and workplace burnout supports targeting organizational-level sources versus individual-level factors as the most effective prevention and reduction strategy. This study elaborates on this evidence by identifying structural drivers of burnout within a multidisciplinary context of pediatric hematology/oncology clinicians.Item The Monetary Impact of Outpatient No-Shows in the Nuclear Medicine Department of a Pediatric Hospital(Office of the Vice Chancellor for Research, 2014-04-11) Moore, MicheleOutpatient no-shows are going to be a regular occurrence for any nuclear medicine department. Hospitals lose thousands of dollars each year from non-attendance. Determining the overall monetary impact of the no-shows and uncovering which procedures contribute most in terms total no-shows and total financial impact is a first step in alleviating some of this loss. Method: From a Nuclear Medicine children’s hospital, six months of data were collected retrospectively from December 2012 through May 2013. This included: procedure, current procedural terminology codes, total number of scans, total number of no-shows, as well as total hospital cost, and total revenue lost. The percentage for each procedure contributing to the total financial impact was calculated by dividing the cost for each procedure by the total loss in revenue. This was done for the total hospital cost (radiopharmaceuticals) and the total revenue loss (technical component). Results: From December 2012 through May 2013 the financial impact for this nuclear medicine department was $17,512.32. The procedures contributing to the most hospital cost were renal dynamic imaging, renal morphology imaging, and gastric emptying, resulting in 54%, 19.2%, 13.4% respectively. The procedures contributing to the most revenue loss were gastric emptying, renal dynamic imaging, and hepatobiliary imaging, resulting in 30.7%, 17.0%, and 13.4% respectively. Conclusion: Outpatient no-shows are going to be a regular occurrence for any nuclear medicine department, but losing money does not have to be. Nuclear medicine departments need to discover ways of eliminating no-shows and identify which procedures contribute to the most financial impact. This is imperative in reducing the amount of revenue lost from wasted radiopharmaceuticals, technologist’s time, and the technical components in a department.Item Pediatric neurosurgery along with children’s hospitals’ innovations are rapid and uniform in response to the COVID-19 pandemic(AANS, 2020) Weiner, Howard L.; Adelson, P. David; Brockmeyer, Douglas L.; Maher, Cormac O.; Gupta, Nalin; Smyth, Matthew D.; Jea, Andrew; Blount, Jeffrey P.; Riva-Cambrin, Jay; Lam, Sandi K.; Ahn, Edward S.; Albert, Gregory W.; Leonard, Jeffrey R.; Neurological Surgery, School of Medicine