Evidence map›Paper›PMID 42602710›Full record

ArticleBJA open2026

Pain Point Elimination Bringing Better Longitudinal Engagement and Satisfaction project: qualitative mixed-methods study investigating a pragmatic intervention on physician well-being.

Rebecca D Margolis, Rachel Schwartz, Hanna Van Pelt, Samuel D Yanofsky, Paola Padilla, Alberto Gutierrez Ramirez, Margaret J Klein, Bashira A Oloso, Erik Arline, Kyle Sanders and 2 more

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In one paragraph

Article in BJA open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Rebecca D MargolisDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Rachel SchwartzDepartment of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA.
Hanna Van PeltDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Samuel D YanofskyDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Paola PadillaDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Alberto Gutierrez RamirezDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Margaret J KleinDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Bashira A OlosoDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Erik ArlineDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Kyle SandersDepartment of Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Laura BerenstainDepartment of Anesthesiology, University of Cincinnati College of Medicine, Hospital Medical Center, Cincinnati, OH, USA.
Amy E VinsonDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Clinician well-being is essential for healthcare sustainability. Burnout and intention to leave remain prevalent in anaesthesiology, yet scalable, evidence-based systems-level interventions are limited. This study aimed to evaluate the impact of a pragmatic, clinician-driven departmental intervention designed to improve daily work experience. We hypothesised that this intervention would reduce burnout and improve related measurements of clinician well-being. Methods: This mixed-methods study assessed the Pain Point Elimination Bringing Better Longitudinal Engagement and Satisfaction (PEBBLES) project across two US paediatric anaesthesiology departments over a 14 month period. Participants engaged in facilitated small-group sessions identifying actionable workplace issues that were iteratively addressed with structured feedback. Impact was assessed using both process measures (post-intervention qualitative focus groups analysed with a combined deductive and inductive thematic approach) and outcome measures (pre- and post-intervention quantitative measures of clinician well-being) to provide a comprehensive evaluation. Burnout was defined as the mean of work exhaustion and interpersonal disengagement as measured by the professional fulfilment index, where higher scores indicate greater burnout. Results: Between April 2023 and June 2024, 75 clinicians participated. Within the matched participants subgroup, interpersonal disengagement decreased significantly at both 3 and 6 months compared with baseline. Overall burnout increased at 3 months but was not different from baseline by 6 months. Work exhaustion decreased significantly at 6 months. Other well-being metrics remained stable. At 12 months, 83.9% reported participation was worthwhile, and 87.1% would recommend the intervention. Qualitative analyses yielded three major themes: increased perceived agency in the local work environment, enhanced perceptions of being valued, and learned hopefulness that seemed to counter cynicism. Conclusions: The PEBBLES intervention was associated with improvements in disengagement and work exhaustion alongside meaningful experiential gains in agency, valuation, and hopefulness. These findings support the feasibility of low-cost, clinician-driven system interventions as practical components of organisational well-being and workforce retention strategies.

Indexed as

agencyburnoutphysician well-beingrelationship-centred interventionworkforce retention

Identifiers

PMID42602710
PMCPMC13475697

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.