Article Text
Abstract
Background Healthcare is approaching a tipping point as burnout and dissatisfaction with work-life integration (WLI) in healthcare workers continue to increase. A scale evaluating common behaviours as actionable examples of WLI was introduced to measure work-life balance.
Objectives (1) Explore differences in WLI behaviours by role, specialty and other respondent demographics in a large healthcare system. (2) Evaluate the psychometric properties of the work-life climate scale, and the extent to which it acts like a climate, or group-level norm when used at the work setting level. (3) Explore associations between work-life climate and other healthcare climates including teamwork, safety and burnout.
Methods Cross-sectional survey study completed in 2016 of US healthcare workers within a large academic healthcare system.
Results 10 627 of 13 040 eligible healthcare workers across 440 work settings within seven entities of a large healthcare system (81% response rate) completed the routine safety culture survey. The overall work-life climate scale internal consistency was α=0.830. WLI varied significantly among healthcare worker role, length of time in specialty and work setting. Random effects analyses of variance for the work-life climate scale revealed significant between-work setting and within-work setting variance and intraclass correlations reflected clustering at the work setting level. T-tests of top versus bottom WLI quartile work settings revealed that positive work-life climate was associated with better teamwork and safety climates, as well as lower personal burnout and burnout climate (p<0.001).
Conclusion Problems with WLI are common in healthcare workers and differ significantly based on position and time in specialty. Although typically thought of as an individual difference variable, WLI appears to operate as a climate, and is consistently associated with better safety culture norms.
- work-life integration
- work-life balance
- burnout
- teamwork climate
- safety climate
- safety culture
- survey
- scale
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Footnotes
Contributors SPS performed the literature search, was involved in data analysis, made the first draft of the manuscript and was involved in all critical revisions of the manuscript. KCA performed the statistical analysis, was involved with manuscript preparation, and all revisions of the manuscript. JB, KJR, TDS and JP were involved with manuscript preparation and revisions. JBS conceived the study and design, was involved in data analysis, statistical analysis, manuscript preparation and all critical revisions. All authors approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests SCORE is available at no cost for research and quality improvement purposes. The Duke Patient Safety Center has a research contract with Safe & Reliable Healthcare to conduct secondary analysis on Safety Culture data. Safe & Reliable Healthcare uses the work-life climate scale in their online platform. TDS is coinventor of the Physician Well-Being Index, Medical Student Well-Being Index, Nurse Well-Being Index and Well-Being Index. Mayo Clinic holds the copyright for this instrument and has licensed it for use outside of Mayo Clinic. TDS receives a portion of any royalties paid to Mayo Clinic. TDS has received honorarium for presenting grand rounds, keynote lectures and advising on the topic of physician well-being. JBS and JP have funding through the NIH through a WISER R01 grant (R01 HD084679-01) to study burnout in healthcare. KCA and JBS have received honorarium for talks in which they discuss WLI and burnout.
Patient consent Not required.
Ethics approval IRB at Duke University deemed exempt from review (IRB number: Pro00083427).
Provenance and peer review Not commissioned; externally peer reviewed.