49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting

•Physician burnout and its correlates negatively affect health care delivery nearly comprehensively with ramifications affecting both providers and patients3.

•“Pebble projects1” attempt to attenuate burnout at its roots by addressing workplace annoyances that may seem minor in isolation but cumulatively are consequential.

•We designed a system to collect and stratify areas for provider experience improvement for a regional anesthesia and acute pain service at a busy academic medical center.

•Primary aim: to develop & evaluate a system that identifies and addresses “pebbles” that may contribute to regional anesthesia personnel burnout.

•Scannable QR code labels were placed on ultrasound machines in the perioperative units. The QR codes allowed users to report their pebbles & propose solutions.

•Collected pebbles were evaluated and categorized by their anticipated timeframe and perceived ease of intervention.

•Solutions were subsequently implemented and broadcast.

•Analysis of the collected pebbles helped to identify root causes and the process effectiveness.

•An 11-question psychological safety assessment2 was applied upon initiation and completion of the project to analyze changes in psychological safety and well-being of the regional team.

•Over 8 weeks, 81% of identified pebbles were solved.

•Most issues were equipment, policy, or environment-related.

•By streamlining a process for provider experience improvement, we were able to clearly define simple workplace problems and identify straightforward solutions.

•Ultimately: We demonstrate an effective way to enhance provider experience.

•The successful uptake of this project highlights the potential impact of basic measures in improving clinical processes and provider experience.

1. A. and Berg, S. (2019) Fix the ‘pebble in the shoe’ problems to cut physician burnout, American Medical Association. Available at: https://www.ama-assn.org/practice-management/physician-health/fix-pebble-shoe-problems-cut-physician-burnout (Accessed: 21 February 2024).
2. Psychological Safety and Learning Behavior in Work Teams” (Amy Edmondson, 1999, Administrative Science Quarterly 44 (2): 350-383)
3. West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529. doi:10.1111/joim.127523. Afonso AM, Cadwell JB, Staffa SJ, Sinskey JL, Vinson AE. U.S. Attending Anesthesiologist Burnout in the Postpandemic Era. Anesthesiology. 2024 Jan 1;140(1):38-51. doi: 10.1097/ALN.0000000000004784. PMID: 37930155.

49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting

A TARGETED FEEDBACK SYSTEM TO IDENTIFY AND MITIGATE ENVIRONMENTAL IRRITATIONS TO IMPROVE REGIONAL ANESTHESIOLOGIST WELL-BEING

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