The role of veterinary team effectiveness in job satisfaction and burnout in companion animal veterinary clinics

• Autores: Irene C. Moore
• Localización: JAVMA: Journal of the American Veterinary Medical Association, ISSN-e 0003-1488, Vol. 245, Nº. 5, 2014, págs. 513-524
• Idioma: inglés
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• Resumen

  • Objective—To determine the role of veterinary team effectiveness regarding job satisfaction and burnout in companion animal veterinary practice.

    Design—Cross-sectional observational study.

    Sample—48 companion animal veterinary health-care teams.

    Procedures—274 team members participated in an online survey. Overall job satisfaction was evaluated with a 1-item measure, and the 3 dimensions of burnout (exhaustion, cynicism, and professional efficacy) were measured with the Maslach Burnout Inventory-General Survey. Team effectiveness was assessed with a survey developed for this study. Demographic and team effectiveness factors (coordinated team environment, toxic team environment, team engagement, and individual engagement) associated with job satisfaction and burnout were evaluated.

    Results—Overall mean job satisfaction score was 5.46 of 7 (median, 6.00); veterinary technicians and kennel attendants had the lowest scores. According to the Maslach survey results, 22.4% of participants were in the high-risk category for exhaustion, 23.2% were in the high-risk category for cynicism, and 9.3% were in the high-risk category for professional efficacy. A coordinated team environment was associated with increased professional efficacy and decreased cynicism. A toxic team environment was negatively associated with job satisfaction and positively associated with exhaustion and cynicism. Individual engagement was positively associated with job satisfaction and professional efficacy and negatively associated with exhaustion and cynicism.

    Conclusions and Clinical Relevance—Results suggested the effectiveness of a veterinary team can significantly influence individual team members’ job satisfaction and burnout. Practices should pay specific attention to the effectiveness with which their veterinary team operates.

    In human health care, advantages of teamwork include reduced hospitalization time and costs, enhanced service provision, improved patient satisfaction, increased staff motivation, and greater team innovation.1 Studies in human health care also reveal that positive team environments enhance job satisfaction, improve well-being, and provide better role clarity for employees.2,3 Conversely, negative team environments have been associated with team members becoming stressed, frustrated, and dissatisfied.4,5 Research has identified dissatisfaction and stress at the individual level to be associated with substance abuse, burnout, turnover, and reduced psychologic well-being in numerous health professions,6–11 including veterinary medicine.6,7,12–14 Occupational and psychological stresses are associated with a high rate of suicide among veterinarians.6,7 A recent study found veterinarians have a disproportionately high risk of suicide, at 4 times the proportional mortality ratio of the general population and twice that of other health professions.6,7 Similar studies have not yet been done with other members of the veterinary team.

    Although several studies have explored job stress, job satisfaction, and burnout among veterinarians,6,12–15 to date, empirical studies have not examined the effect of team effectiveness on the outcomes of job satisfaction and burnout in the entire veterinary team.

    Although a broadly accepted definition of team effectiveness has not been developed, it is generally thought to consist of inputs, processes, and outputs.2,3,16 Inputs include organizational-level factors such as specified tasks, distinct roles, and relevant members2,17–19 and individual-level factors such as self-knowledge, commitment, and flexibility.2,17,18,20,21Team processes usually include leadership, communication, coordination, and conflict resolution,4,22–24 and outcomes include turnover, profitability, patient care, and client satisfaction.2,3,16 Job satisfaction is one of the most researched variables in organizational behavior.25 It has an effect on the organization in terms of performance26,27 and outcome quality measures,28 and it also influences an individual's physical health (eg, cardiovascular disease and musculoskeletal disorders)29 and psychological well-being (eg, anxiety and depression).25,29,30 Furthermore, studies have found job satisfaction to be positively associated with organizational commitment31–35 and negatively associated with job turnover.32–34,36,37 Burnout is defined as a syndrome of emotional exhaustion, cynicism, and decreased professional efficacy and leads to decreased effectiveness at work.38 Emotional exhaustion (hereafter referred to as exhaustion), a key component of the burnout syndrome, is characterized by decreased emotional energy as a result of excessive personal or work demands.38 Cynicism represents a dysfunctional, self-protective coping mechanism for chronic work stress and exhaustion, with workers withdrawing from various aspects of the job as well as from coworkers and clients.38–40 In contrast, professional efficacy describes feeling personally capable of completely fulfilling expectations of the job or occupation.38 High exhaustion and cynicism scores and low professional efficacy scores have been associated with higher levels of negative physical and mental health outcomes in a number of professions.38 Previous studies indicate exhaustion usually precedes cynicism,39,40 and cynicism can result in decreased professional efficacy,41 although burnout is said to be present with extreme scores in even just 1 domain. The objective of the study presented here was to evaluate the effect of veterinary team effectiveness on the outcomes of job satisfaction and burnout in companion animal veterinary practice. It was hypothesized a priori that higher ratings of veterinary team effectiveness would result in higher individual job satisfaction and less individual burnout in a veterinary practice setting.