Incorporating Behavioral Health Providers onto Inpatient Medical Teams: A Feasibility Study.

Behavioral health providers (BHPs) have long been incorporated into clinical medical settings, however, they have yet to be included in inpatient hospital settings. Inclusion of BHPs in this setting is logical given the high rates of psychosocial problems experienced by hospitalized patients and because BHPs can effectively treat psychosocial challenges, including mental health disorders and behavioral health difficulties. We worked to determine the feasibility of incorporating BHPs onto the inpatient medical team and to discover if integrating BHPs onto the team could decrease the barriers present in standard consult-liaison models of care. Researchers collected information on patient and provider satisfaction with BHP services and tracked admission diagnosis, reasons for referral, and interventions delivered. Results indicated that the integration of BHPs onto the inpatient team is feasible and reduces numerous barriers. The incorporation of BHPs onto inpatient medical teams can mitigate barriers experienced within the current consult-liaison model.

Risk and protective factors for burnout among physicians from standardized residency training programs in Shanghai: a cross-sectional study.

BACKGROUND: High burnout has been reported in physician populations. Although the standardized residency training (SRT) in China includes components that might put residents at a higher risk for burnout, the burnout of Chinese medical residents is unknown. This study aimed to evaluate the prevalence of burnout and the associated risk and protective factors for medical residents in the SRT program in Shanghai, China. METHODS: This study was a prospective cross-sectional design. A random sampling strategy was used to recruit 330 resident physicians from four SRT sites in Shanghai, and 318 completed questionnaires were returned. Respondents completed a self-made questionnaire including demographic and work characteristics, four burnout and wellness-specific surveys. Bivariate analyses and hierarchical multiple regression models were used to analyze factors associated with three sub-scales of burn out separately. RESULTS: The overall burnout rate was 71.4%. Low level rate of personal accomplishment (PA) was extremely high at 69.5%. Night shift experience, high occupational stress, and low social support were significant predictors, which explained 49.1% variance of emotional exhaustion (EE) (F = 26.528, P < 0.01). Factors that significantly predicted depersonalization (DP) included male gender, senior residents, night shift experience, high occupational stress, and low psychological empathy, which explained 51.5% variance totally (F = 29.004, P < 0.01). Senior residents, high income, low occupational stress, and high empathy were also significant predictors of decreased personal achievement (PA), which explained 18.4% variance totally (F = 12.897, P < 0.01). CONCLUSIONS: There was a high burnout rate among SRT residents in Shanghai. Occupational stress and several work-related factors were significant and strong risk factors for burnout, while empathy and social support were mild protective factors. Decreased work-related demands and increased access to resources could assist residents in reducing their work stress and improving their well-being.