Table 3.
Change in Provider and Staff Morale, Job Satisfaction, and Freedom from Burnout by PCMH Score Change Group
| Provider/staff-rated PCMH score‖ change group | Provider | Staff | ||||||
|---|---|---|---|---|---|---|---|---|
| n | Good/better morale | Job satisfaction | Freedom from burnout | n | Good/better morale | Job satisfaction | Freedom from burnout | |
| Decrease (more than − 3 points) | 14 | − 27.9 (− 50.5, − 5.4)‡ | − 48.9 (− 64.2, − 33.6)* | − 22.2 (− 39.4, − 4.9)‡ | 13 | − 27.4 (− 45.8, − 8.9)‡ | − 12.9 (− 30.3, 4.6) | − 9.3 (− 29.2, 10.7) |
| No change (− 3 to + 3 points) | 17 | − 10.8 (− 31.2, 9.7) | − 3.7 (− 17.6, 10.3) | − 9.3 (− 25.0, 6.4) | 21 | 5.6 (− 8.9, 20.2) | − 6.8 (− 20.5, 7.0) | 3.3 (− 12.4, 19.0) |
| Moderate increase (+ 3 to + 9 points) | 14 | 0.8 (− 21.7, 23.4) | − 5.8 (− 21.1, 9.5) | − 15.8 (− 33.0, − 1.5)‡ | 15 | − 1.5 (− 18.7, 15.7) | − 6.4 (− 22.6, 9.9) | 10.3 (− 8.3, 28.9) |
| Large increase (more than + 9 points) | 14 | 14.3 (− 8.3, 36.8) | 7.2 (− 8.1, 22.6) | 5.4 (− 11.9, 22.7) | 10 | 19.1 (− 1.9, 40.1)§ | 11.6 (− 8.3, 31.5) | 15.9 (− 6.9, 38.6) |
| ANOVA p value (difference across groups) | 0.065 | < .001 | 0.144 | 0.009 | 0.304 | 0.353 | ||
*p < .001
†p < .01
‡p < .05
§p < .1
‖Lewis SE, Nocon RS, Tang H, Park SY, Vable AM, Casalino LP, et al. Patient-centered medical home characteristics and staff morale in safety net clinics. Arch Intern Med. 2012 Jan 9;172(1):23–31
PCMH, patient-centered medical home; ANOVA, analysis of variance
Analyses are conducted at the clinic level; independent variables are summarized as average values among respondents from each clinic. Cells show clinic-level average change (95% confidence interval) in percent providers/staff reporting good/better morale, job satisfaction, and freedom from burnout
Responses to single-question instruments for morale, job satisfaction, and burnout on a 5-point Likert-type scale were collapsed as follows: For morale, “poor” and “fair” were combined vs “good,” “very good,” and “excellent.” For job satisfaction, “strongly disagree,” “disagree,” and “neither agree nor disagree” were combined vs “agree” and “strongly agree.” For burnout, “I feel completely burned out and often wonder if I can go on,” “The symptoms of burnout that I am experiencing will not go away. I think about frustrations at work a lot,” and “I have one or more symptoms of burnout, such as physical or emotional exhaustion” were combined vs “Occasionally I am under stress at work, but I do not feel burned out” and “I enjoy my work. I have no symptoms of burnout”