From Burnout to Buy-In: Using Appreciative Inquiry to Build Engagement Within a Hospital Medicine Group.

Abstract

Poor frontline clinician engagement negatively impacts patient safety and quality of care and increases clinician burnout and clinician attrition. Use appreciative inquiry (Ai) to improve hospitalist and physician associate (PA) engagement including job satisfaction, retention, and professional development over 1 year. Interdisciplinary hospital medicine group comprised of 47 hospitalists and PAs at a community-based university-affiliated urban hospital. Six frontline hospitalists and PAs formed a PA-Hospitalist Task Force to improve engagement using Ai which fosters autonomy, competence, and relatedness, key tenets of self-determination theory. The Task Force used surveys and focus groups to foster collaboration and empower frontline clinicians to capitalize on existing strengths to shape best practice guidelines. Of those eligible to participate, 74% (14/19) of hospitalists and 84% (16/19) of PAs participated in focus groups. Within a year, participants reported that interventions improved job satisfaction and professional development and enhanced motivation and meaning in work. PA retention increased by 20%. Ai is a powerful tool to foster frontline engagement within hospital medicine groups. Our methods can be applied to other practice settings and inter-professional groups.