Factors influencing emergency medicine worker shift satisfaction: A rapid assessment of wellness in the emergency department

Abstract

Objectives: In emergency medicine (EM), the interplay of wellbeing and burnout impacts not only patient care, but the health, productivity, and job satisfaction of EM healthcare workers. The study objective was to use a rapid assessment tool to identify factors that impact EM worker satisfaction, or "wellness," while on shift in the emergency department (ED) and the association with role and level of satisfaction. Methods: This prospective descriptive study utilized a QR-code-based electronic survey instrument that included a 7-point Likert shift satisfaction score. A voluntary response sampling was obtained from EM workers at five EDs. Respondents self-reported role and work site. Association and logistic regression analysis were performed. Results: Of 755 responses, 467 were dissatisfied (score ≤ 5) and 288 were satisfied (score ≥ 6) with their shifts. Physicians reported higher satisfaction on shift than nurses (OR 2.77, 95% CL 2.01-3.81, p < 0.01). Factors associated with dissatisfied responses included: admission or transfer process (OR 0.40, CL 0.21-0.77, p < 0.01), boarding patients (OR 0.13, CL 0.06-0.27, p < 0.01), tools to do my job (OR 0.65, CL 0.46-0.90, p = 0.01), and patient flow (OR 0.72, CL 0.53-0.98, p = 0.04). Factors linked to a satisfied response included: teaching/learning (OR 2.85, CL 1.86-4.37, p < 0.01) and team/coworker interaction (OR 8.92, CL 6.14-12.96, p < 0.01). Conclusions: Satisfaction on shift for EM physicians, nurses, and staff differ and are associated with multiple identifiable factors. Focused attention to work environment and operations could help mitigate on-shift dissatisfaction. Endeavors aimed at cultivating and enhancing a supportive teaching and learning environment with an emphasis on team member and coworker interaction could positively impact and improve wellness.