Wellbeing: Overview + SIG resources

From shift planning, to patient flow management, along with the development of dedicated training pathways and addressing trainer fatigue, the authors also discuss the central role Emergency Departments play in the healthcare system, the importance of safety standards, and practical solutions to addressing burnout, attrition and the transition from Triple to Quadruple Aim. Fruit of an international collaboration, this collection of articles brings together authors from all parts of the world, and unites them towards a common goal: improving wellbeing for the specialists responsible for maintaining the safety net that is Emergency Medicine.

Abstract
Purpose: This study aims to investigate autonomy support and self-valuation as potential mechanisms by which supportive leadership improves physician well-being. Supportive leadership is one of the strongest predictors of physician well-being. However, mechanisms by which leadership behavior influences well-being remain unknown. The authors hypothesized that autonomy support and self-valuation mediate this relationship.

Design/methodology/approach: This was a cross-sectional survey-based study of physicians in a tri-hospital cardiovascular health system in southwestern USA. An anonymized multidimensional questionnaire comprising standardized and pre-validated measures of leadership behavior, self-valuation, autonomy support, fulfillment and burnout was e-mailed to 815 eligible physicians in February 2024. Hypothesized multivariable pathways were investigated via structural equation modeling.

Findings: In total, 122 participants answered the survey, 99 providing complete responses. Respondents were 75.76% male, 54.54% aged 41 to < 65 years, 44.44% white, 21.21% Asian and 52.52% in practice for ≥ 15 years. Reliabilities of ordinal scales were all ≥ 0.700, and univariate correlations were in expected directions. Fully, 24.24% of respondents were burned out, 63.64% professionally fulfilled, 70.71% had high autonomy support and 55.56% high self-valuation. Indirect effects of leadership support on fulfillment and burnout, mediated via autonomy support and self-valuation, were more significant than direct effects. Findings supported the study hypothesis that leadership support improves fulfillment and reduces burnout among physicians partly by fostering autonomy and self-valuation.

Originality/value: Autonomy support and self-valuation within physician teams are highlighted as factors whose improvement well-being-centered leadership training programs specifically should target.