An SMS based system to continuously monitor stress in physicians.
What is CalmDoc?
CalmDoc is a text-based system to continuously follow physician stress levels in their native environment. Our system sends one single-item stress question (SISQ) per week via text at random times (between 9a and 4p) and days (Mon-Fri). It has been shown that SISQ scores correlate with exhaustion, workplace injury, sense of control/reward, depression, and intention to leave. Our simple assessments occur continuously and are coordinated throughout an institution providing numerous stress data points weekly. Assessing stress and burnout in this manner highlights where interventions are most needed both temporally (i.e., when stress and burnout rates are the highest) and spatially (i.e., where in the hospital burnout “hot spots” emerge).
There’s an epidemic of stress and burnout in physicians.
Even before the pandemic, physician stress and burnout were at epidemic proportions (45-75%). The associated emotional exhaustion and compassion erosion leads to poor quality care. The resulting errors and reduced patient satisfaction and compliance causes hospitals to lose millions of dollars annually. In addition, burned-out physicians are twice as likely to quit resulting in replacement costs of 2-3 times their annual salary and costing the US ~$4 billion annually.
Institutions must evaluate the extent of the problem using validated measures. Currently such measures are administered irregularly with minimal coordination. The experience of stress fluctuates making infrequent assessments ineffective and subject to recall bias. In addition, compliance is generally poor with response rates of 40-50% being common, but often significantly lower. The ideal assessment system should be simple, coordinated, frequent, and engaging.
The ideal stress assessment system.
Text-based surveys have been shown to be invaluable in healthcare with response rates of 90-98%. Ecological Momentary Assessments (EMAs), which involve repeated sampling of experience in real-time, minimize recall bias and maximize in-the-moment validity. Instead of asking a participant to reflect on a variable timeframe to answer a series of questions about how they felt, this method of questioning ask how the participant feels at a particular moment, eliminating recall bias. These questions are then repeated to develop a better concept of the individual’s experience as it is lived in real-time across contexts.
Why CalmDoc is the ideal system.
Calm Doc is…
Dr. Byron Fergerson is a Clinical Professor in the UCSD Department of Anesthesiology specializing in Cardiothoracic Anesthesia and Echocardiography. He’s been studying, lecturing, and promoting physician wellness for almost a decade. He has served as the Wellness Director for the Anesthesiology department and is currently Vice-Chair of Faculty Wellness and Engagement. Dr. Fergerson is also Chair of the UCSD Wellness Director Committee and is active in wellness initiative development throughout UCSD. Dr. Fergerson has received training in peer support communication, Mindfulness-Based Stress Reduction, Compassion Cultivation, and advanced training in Mindfulness facilitation. He has completed the UC Davis/Irvine Clinician Health and Well-Being Fellowship the Stanford Physician Well-Being Course both of which aim to teach how to identify and treat psychosocial problems; implement preventative health measures; and engage, treat, and monitor impaired physicians.