Impact of A Reward Efficiency, Set Priorities, Empower Teams (RESET) Pilot Program

Impact of A Reward Efficiency, Set Priorities, Empower Teams (RESET) Pilot Program

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Name: Crystal Aandahl

Rank: LCDR

Presenter/Poster: Presentation and Poster

Year: 2019

Abstract

Background: An estimated national rate of primary care provider burnout rate across civilian, Veterans Affairs, and military health centers is 30-65%. (Edwards, Kim & Stockdale, 2017; Linzer et al., 2013; Sargent et al., 2016; Shanafelt et al., 2012).  Provider burnout impacts provider productivity, patient-provider continuity, and patient access (Perzynski, Caron, Margolius & Sudano Jr., 2018; West, Dyrbye, Erwin, & Shanafelt, 2018). The use of a templated virtual appointment mechanism has been shown to improve these primary care metrics (Lutz, et al., 2018).

Objective: Will a Reward Efficiency, Set priorities, and Empower Teams (RESET) – based program in the Family Medicine department at a Military Treatment Facility in the Pacific Northwest improve outcomes of provider burnout, patient-provider continuity, and access to care when compared to the usual state?

Methods:  A pre-post-test survey design was used. RESET best practices were disseminated to departmental leadership. Three Family Medicine teams participated in the survey and one team piloted the RESET model. The Mini-Z burnout survey was administered to staff members of the three Family Medicine teams before and within three months of the RESET rollout. T-tests were performed to compare the average change in provider burnout, patient-provider continuity, and access to care.

Analysis of the Results: Data analysis is still ongoing. Preliminary data indicate the following results: baseline Mini-Z survey response rate was 80% and 90% with 20 paired participants across three teams. No statistically significant difference was seen in burnout ratings or continuity between the usual group and RESET group. There was a moderate change in effect size for burnout and a high change in effect size for continuity between the usual and RESET groups. These are noteworthy findings given the small sample size.

Implications for Military Nursing: RESET (virtual appoints) can be used to address provider productivity, patient-provider continuity, and access to care in Family Medicine clinics.  The development of higher-level studies evaluating health quality indicators related to virtual health appointments is needed.

4 Keywords: RESET, Burnout, Access, Continuity