Impact of obstetrics and gynecology resident workload and protected time interventions on well being

Background: Between 22% and 60% of practicing physicians are reported to have experienced burnout, with OB/GYN resident burnout having been reported at 90%. Duty-hour limitations were implemented for patient safety and have been associated with some increase in overall resident quality of life and potential sacrifices in resident education and patient care. Contributors to burnout (and drivers of engagement) include workload and job demands, lack of control and flexibility over personal schedule and workload, poor work-life integration, and numerous check box requirements (filling out surveys, module requirements, duplicates, paperwork). Purpose: To improve well-being and decrease burnout among OB/ GYN residents by implementing workload changes and protected time for wellness. Methods: Effective July 2017, we changed 3 resident workload protocols. 1) For weekend rounding, residents continue to round on all antepartum and gynecology patients at the end of each 24-hour shift, but faculty became responsible for completing all postpartum rounding. 2) Weekday postpartum rounding was redistributed, and the number of patients decreased from \u3e10 to maximum of 6–7 patients per junior resident. 3) No resident service obligations on Sundays with 2 months with no residents on night float. Quarterly wellness mornings began in September 2017, using protected education time for residents. We measured pre/post changes in well-being through a brief well-being check in card (WBCIC) and Mayo Well-Being Index (MWBI). Results: Resident response rates ranged from 10 to 12. WBCIC baseline (September 2017), midintervention (May 2018), and postintervention (December 2018) scores on item “Time spent on wellbeing” improved from 1.6 to 2.1 to 2.3 (scale: 1=pitiful to 4=excellent). The item “The work I do is meaningful to me” began at 4.9, then remained constant at 5.2 (scale: 1=strongly disagree to 7=strongly agree). The MWBI identifies those at risk of adverse outcomes due to poor quality of life, burnout, and suicidal ideation if their score is \u3e5. MWBI scores remained more than 1.2 points below the 5.0 cutoff, ranging from 1.2 to 1.8 during report period with seasonal variation (residents were less well in winter). Wellness mornings were most frequently used for sleep, connecting with family/ friends/other residents, exercise, and personal health appointment. Conclusion: The workload interventions were associated with a positive trend in overall well-being and finding meaning in work, making progress towards our goal of creating a workplace dynamic where burnout is combated and well-being is promoted