Pediatric Provider and Staff Burnout in Federally Qualified Community Health Centers
Boston, MA- A new study published in the Journal of Ambulatory Care Management (JACM) examines burnout among pediatric providers and staff in federally qualified community health centers (FQHCs). The study, titled "Pediatric Provider and Staff Burnout in Federally Qualified Community Health Centers," was conducted by a team of researchers from Boston Medical Center. The study examines differences in burnout between pediatric primary care providers (PCPs), behavioral health clinicians (BHCs), and community health workers (CHWs) who were part of integrated behavioral health care teams at FQHCs that implemented the TEAM UP Model of care.
TEAM UP for Children—Transforming and Expanding Access to Mental Health Care in Urban Pediatrics— is a pediatric integrated behavioral health initiative co-developed by Boston Medical Center and seven FQHCs designed to equip health centers to deliver high-quality, evidence-informed, trauma-responsive, integrated behavioral health care in historically marginalized communities. In these health centers, where 74% of the patient population is from a racial and/or ethnic minoritized group, 37% are best served in a language other than English, and 67% live at or below the federal poverty level, TEAM UP has created a sustainable, adaptable, and replicable model that strengthens pediatric primary care.
"Health care, like many industries, is facing a workforce shortage just as the demand for mental health services is dramatically increasing. Children – particularly low-income children– face significant barriers in accessing mental health services and a struggling workforce can contribute to those barriers," said Dr. Chris Sheldrick. "Workforce challenges must be addressed to ensure at-risk children have access to high-quality care. The TEAM UP Model aims to address these challenges through a team-based approach to integrating behavioral health care into primary care at FQHCs, where children from historically marginalized communities regularly access care."
The survey was conducted at a pre-pandemic “baseline” and pandemic “follow-up” 18 months into the implementation of the TEAM UP model, and it surveyed pediatric providers and staff at four FQHCs in Massachusetts. The objectives were to examine the differences in burnout between PCPs, BHCs, and CHWs, and to examine changes over time in burnout rates. The survey assessed burnout using the Maslach Burnout Inventory—a 22-item questionnaire designed to assess emotional exhaustion, depersonalization, and personal accomplishment.
Survey results suggest that PCPs had higher levels of burnout compared to their BHCs and CHWs colleagues at TEAM UP FQHCs. Over the study period, burnout increased across all roles. Working as part of integrated behavioral health care teams at FQHCs during the pandemic, though, PCPs and BHCs continued to have lower rates of burnout than physicians and psychologists nationally.
"This study provides important insights into the factors that contribute to burnout among pediatric providers and staff in FQHCs," said Cameron Hill, MPH, the study's lead author. "The findings suggest that burnout is a complex issue influenced by individual and organizational factors. We need to take a comprehensive look at the factors that influence burnout to protect the well-being of our health care workforce and ensure that they can provide high-quality care to the children and families they serve."
The researchers hope their findings will encourage more FQHCs to implement actionable change to address provider and staff burnout.
This study highlights the importance of addressing provider and staff burnout as vital to meeting the needs of children and families when accessing mental health services. Integrating mental health services into pediatric primary care in FQHCs can address workforce challenges to ensure access to mental health care for children in historically marginalized communities.
Citation: Hill, Cameron MPH; Justo, Stacy MA; Park, Hannah MPH; Bair-Merritt, Megan MD, MSCE; Morris, Anita MSN, FNP-BC; Feinberg, Emily ScD, CPNP; Sheldrick, R. Christopher PhD. Pediatric Provider and Staff Burnout in Federally Qualified Community Health Centers. Journal of Ambulatory Care Management 46(4):p 265-271, October/December 2023. | DOI: 10.1097/JAC.0000000000000472
Authors: Hill, Cameron MPH; Justo, Stacy MA; Park, Hannah MPH; Bair-Merritt, Megan MD, MSCE; Morris, Anita MSN, FNP-BC; Feinberg, Emily ScD, CPNP; Sheldrick, R. Christopher PhD.
Department of Pediatrics, Boston Medical Center/Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts (Mr Hill and Mss Justo, Park, and Morris and Drs Bair-Merritt and Feinberg); and Department of Psychiatry, UMass Chan Medical School, Worcester, Massachusetts (Dr Sheldrick)
Corresponding Author: Cameron Hill, MPH, Boston University Chobanian and Avedisian School of Medicine/Boston Medical Center, firstname.lastname@example.org
Peggie Bobo, Communications Manager, TEAM UP for Children, Peggie.email@example.com