Evaluating a Canadian tertiary care emergency department physician wellness program

In response to increasing physician moral distress, the Department of Emergency Medicine at an academic, tertiary care hospital established a physician wellness program in 2018. We conducted a program evaluation at the 5-year mark which included the development of a program evaluation framework.

We used a utilization-focused logic model for the wellness program as per Van Melle. We identified inputs-outputs-outcomes and analyzed multiple data sources. These sources included qualitative and quantitative feedback from physicians, participation data from wellness initiatives, exit surveys, and engagement in departmental committees.

Over 5 years, the program periodically collected data on self-reported wellness of attending physicians along with participation data. In 2023, physicians ranked their occupational wellness at 5.93 on a 10-point Likert scale, with 58% highlighting supportive colleagues as their main protective factor and 42% identifying sequelae of emergency department crowding as a negative factor. Of survey respondents, 65% felt the program positively impacted their occupational wellness. Successful initiatives included public appreciation of physicians and creation of a "process map" to help guide physicians through a patient complaint. However, other initiatives such as wellness drop-in sessions were less successful.

While social events were appreciated, initiatives focusing on addressing barriers to occupational wellness were valued the most. This program evaluation and logic model guided the planning committee to emphasize enhancing occupational wellness, recognizing physician accomplishments, and improving patient relations. It served as an operational example for the development and implementation of a wellness program within a large, tertiary care emergency department. Other centers can implement similar activities to create or further enhance their wellness programs.