COMPARISON OF HOSPITALIST MORALE IN A COVID ALTERNATE CARE SITE TO CONVENTIONAL HOSPITALS IN MARYLAND

Background: Provider morale is an important concern for hospitals, particularly during the COVID pandemic. Data from hospitals and alternate care sites (ACSs) have found low morale in hospitalists and nurses working with COVID patients. We compared hospitalist morale at a COVID ACS to regional conventional hospitals using the validated Hospitalist Morale Index (HMI).

Methods: Using the HMI, hospitalists were surveyed at the ACS, Baltimore Convention Center Field Hospital (BCCFH), and five regional conventional hospitals in Spring 2021. Five domain scores were calculated from questions on a 5 point rating scale for importance and satisfaction: Clinical, Workload, Material Rewards, Leadership, and Appreciation/Acknowledgement

Results: Of 76 BCCFH hospitalists, 61 (80%) responded. Of the 183 conventional hospitalists, 141 (77%) responded. The BCCFH and conventional hospitalists were demographically similar. Self-rated burnout and emotional exhaustion/depersonalization were significantly higher in the conventional group compared to the BCCFH group (47% vs. 6% and 23% vs. 4%, respectively). General quality of life was rated in the top 2 quintiles by 91% of the BCCFH group versus 69% of the traditional group. 67% of BCCFH hospitalists were “tremendously” invested in making their group outstanding, the top quintile category, versus 33% of conventional hospitalists. BCCFH hospitalists rated most HMI domains higher than conventional hospitalists. The largest differences were in the Clinical and Appreciation/Acknowledgement domains. In the Clinical domain, opportunity for professional growth (2.78 vs. 2.46), ratio of face time to documentation (3.10 vs. 2.36), relationship with patients (3.40 vs. 3.10) and intellectual stimulation (3.17 vs. 2.83), all were significantly higher than for conventional hospitalists. In the Appreciation/Acknowledgement domain, BCCFH again outranked conventional hospitalists, most clearly in the category “feeling valued in your organization,” 3.28 vs. 2.61.

Conclusions: Hospitalist morale at the BCCFH was significantly better than at regional conventional hospitals during the COVID pandemic. In contrast to most hospitals, BCCFH was staffed exclusively by a self-selected group of providers hired after the pandemic began. Data and comments showed that sense of mission and the face to face patient care at the BCCFH, with less time spent on documentation, and the opportunities for professional growth and feeling valued, may have positively impacted morale.