Issue link: https://beckershealthcare.uberflip.com/i/821337
76 CMO / CARE DELIVERY amazing. So of course we are trying to recon- cile these seemingly contradictory results." Actually, the discrepancy is not indicative of a contradiction; rather, it illuminates an is- sue with the way some engagement surveys are used. Mainly, the engagement surveys Carilion administered do not measure en- gagement as defined by Drs. Maslach and Leiter — the intersection of energy, involve- ment and efficacy — which represents the functional opposite of burnout. If they had, it might be possible to accurately estimate general burnout levels based on their results. Instead, the surveys that were used measure satisfaction with the specific organization as a work environment and physicians' com- mitment to its mission. "When you look at how engagement is be- ing used in all of the employee engagement surveys, they are talking about something completely different" than how Dr. Maslach defines it, says Mark Greenawald, MD, vice chair for academic affairs of the Carilion Clinic Department of Family and Commu- nity Medicine and chair of the Carilion Pro- fessional Well-Being Committee. "ey are using that same word, 'engagement,' but what they're talking about is engagement with the mission of the organization. ey're asking — on a more superficial level — 'Do you like what you do?' and 'Are you satisfied at work?' and 'Would you recommend this job to your friends as a great place to work?'" Even though they are called "engagement surveys," these questions measure one's level of commitment to the organization and satis- faction with the work environment, which do not cumulatively produce engagement. Re- spondents that are actually burned out might respond positively to questions such as these, which would lead to high scores and, as a re- sult, conceal true burnout levels. How to select surveys that accurately measure engagement and burnout Engagement surveys that are not psychomet- rically validated — meaning they are not de- veloped based on the definition of engagement that was established by Drs. Maslach and Leit- er and verified by research — cannot be used as a de facto measure of burnout, according to Monique Valcour, PhD, an executive coach, keynote speaker, management professor and contributor to the Harvard Business Review. "What people do in companies to measure [burnout and engagement] oen diverges pretty far from the definitions that have been established in research," says Dr. Valcour. "We see this a lot with engagement. Compa- nies put together their own surveys and create their own questions." is is not to say that different types of em- ployee engagement surveys don't yield valu- able insight. However, it is important to un- derstand exactly what each survey actually measures. "It depends what the organization's purpose is," says Dr. Valcour. "Most organizations are interested in promoting a work environ- ment that helps to motivate their employees and to facilitate everyone's performance and well-being." If health system leaders aim to know how sat- isfied their physicians are with the organiza- tion and their particular work environment, then surveys that measure job satisfaction, commitment and alignment with the organi- zation will be useful. If a hospital's objective is to accurately diag- nose the rate of physician burnout so they can intervene appropriately, their best bet is to administer both engagement and burnout surveys, and not rely on the results of en- gagement surveys alone to suggest the rate of burnout. According to Dr. Greenawald, hospital ad- ministrators tend to favor administering engagement surveys over burnout surveys because the results are less explicitly nega- tive; mediocre engagement scores don't seem as bad as high burnout scores. However, if health system leaders truly want to help solve the problem, both engagement and burnout surveys should be used. When it comes to selecting surveys, Dr. Val- cour suggests administrators "choose one that is psychometrically validated and be a discerning consumer of surveys. If you are using a consultancy firm, ask them specifi- cally how they developed the measure and if it is validated," she says. "Lots of consultants who are putting together these measures typ- ically don't have the expertise to do so. e results you get back may not be measuring what you think." She suggests using the Maslach Burnout In- ventory. Developed by Drs. Maslach, Leiter and other colleagues, the MBI is validated by 25 years' worth of research and is recognized as the leading measure of burnout. It surveys respondents on the three burnout compo- nents — exhaustion, cynicism and inefficacy — to provide a comprehensive and accurate burnout assessment. n Summa Health Stripped of Emergency Residency Program Accreditation After Appeal Denied By Emily Rappleye A kron, Ohio-based Summa Health System's emergency residency pro- gram lost accreditation after its appeal was denied by the Accreditation Council on Graduate Medical Education, according to a report from the Akron Beacon Journal. The system is also still temporarily prohibited from starting any new residency programs or expanding existing ones, according to the report. The 30 residents in Summa's emergency medicine residency at Akron (Ohio) City Hospital must now transfer to different programs by July 1. Summa Health is assisting resi- dents in finding new programs, according to the report. No additional details were available about the appeal or why it was denied. The residency program was originally suspended because residents were treat- ing and discharging patients in the emergency department without physician supervision, there were delays in stroke and trauma care and the new emergen- cy medicine faculty was not qualified to teach, according to the report. Issues within Summa Health's ED began at the New Year, when it switched the physician group staffing its ED with little warning. Since then, Summa Health has been in turmoil — its residency program was suspended, its CEO stepped down and it faced a Joint Commission investigation. The Joint Commission cleared Summa Health after a patient safety complaint, noting only one minor deficiency: One of the newly-staffed physicians began treating patients before the credentialing process for that physician was complete. n