6. ENCOURAGING JEOPARDY USE FOR MENTAL HEALTH AND FATIGUE, AND ITS IMPACT ON RESIDENT WELLNESS

Abstract

BackgroundResidents who require absence from clinical duties due to illness, emergency, or fatigue are covered at our program through a jeopardy system. The pool of residents is composed of 3 to 4 senior-level residents. In response to 2017 ACGME survey data, program leadership updated our Fatigue Management Policy to include Jeopardy as an option. Leadership attempted to impact residency culture with a “wellness-inclusive Jeopardy policy” by encouraging the use of Jeopardy for mental health, wellness, and management of fatigue.ObjectiveAssess the impact of a wellness-inclusive Jeopardy policy by measuring number of calls, reason, and burnout scores.MethodsA database of Jeopardy use maintained by Chief Residents from 2014-2018 was reviewed, including number of calls per year and the reasons provided for calls. Maslach Burnout Inventory scores and the ACGME Resident Survey data were reviewed and compared before and after the adoption of a wellness-inclusive Jeopardy policy.ResultsIn the 3 years prior to the adoption of the new Jeopardy policy, residents cited mental health or wellness needs 3.3% of the time. In the 1.5 years since residents cited mental health or wellness needs 9.5% of the time. The number of total calls increased significantly over 4 years from 81 calls in 2014-15 to 169 calls in 2017-18, a 109% increase. Resident complement increased 13% in the same period. PGY-1 end of year burn out inventory scores from 2016-2018 decreased from 45% to 28%. ACGME survey scores on providing fatigue transitions improved from 3.3 to 4.4 between 2017 and 2018 surveys.ConclusionsWhile multiple initiatives within our program may have driven improvement in burnout scores, residents responded to wellness-inclusive Jeopardy policy with increased utilization of Jeopardy as a whole and for wellness or mental health reasons. Residents reported more awareness of options to transition care when fatigued. Increased utilization of Jeopardy as a tool for decreasing burnout warrants further discussion regarding improved experience for the residents providing coverage given this increased frequency. Residents who require absence from clinical duties due to illness, emergency, or fatigue are covered at our program through a jeopardy system. The pool of residents is composed of 3 to 4 senior-level residents. In response to 2017 ACGME survey data, program leadership updated our Fatigue Management Policy to include Jeopardy as an option. Leadership attempted to impact residency culture with a “wellness-inclusive Jeopardy policy” by encouraging the use of Jeopardy for mental health, wellness, and management of fatigue. Assess the impact of a wellness-inclusive Jeopardy policy by measuring number of calls, reason, and burnout scores. A database of Jeopardy use maintained by Chief Residents from 2014-2018 was reviewed, including number of calls per year and the reasons provided for calls. Maslach Burnout Inventory scores and the ACGME Resident Survey data were reviewed and compared before and after the adoption of a wellness-inclusive Jeopardy policy. In the 3 years prior to the adoption of the new Jeopardy policy, residents cited mental health or wellness needs 3.3% of the time. In the 1.5 years since residents cited mental health or wellness needs 9.5% of the time. The number of total calls increased significantly over 4 years from 81 calls in 2014-15 to 169 calls in 2017-18, a 109% increase. Resident complement increased 13% in the same period. PGY-1 end of year burn out inventory scores from 2016-2018 decreased from 45% to 28%. ACGME survey scores on providing fatigue transitions improved from 3.3 to 4.4 between 2017 and 2018 surveys. While multiple initiatives within our program may have driven improvement in burnout scores, residents responded to wellness-inclusive Jeopardy policy with increased utilization of Jeopardy as a whole and for wellness or mental health reasons. Residents reported more awareness of options to transition care when fatigued. Increased utilization of Jeopardy as a tool for decreasing burnout warrants further discussion regarding improved experience for the residents providing coverage given this increased frequency.