Burnout Assessment


Questions drawn mainly from the Physician Worklife Study, MEMO study, and Healthy Workplace study. The Mini Z was developed by Dr. Mark Linzer and team at Hennepin County Medical Center, Minneapolis MN. For more information please view our website: http://www.cpperesearch.org/
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Overall, I am satisfied with my current job: *


 
Using your own definition of "burnout", please check one of the answers below: *


 
My professional values are well aligned with those of my department leaders. *


 
The degree to which my care team works efficiently together is: *


 
My control over my workload is: *


 
I feel a great deal of stress because of my job. *


 
Sufficiency of time for documentation is: *


 
The amount of time I spend on the electronic health record (EHR) at home is: *


 
The EHR adds to my frustration of my day *


 
Which number best describes the atmosphere in your primary work area: *


 
The next set of questions relate to stress.

 
Over the last two weeks,
how often have you been bothered by feeling nervous, anxious, or on edge? *


 
Over the last two weeks,
how often have you been bothered by not being able to control or stop worrying? *


 
Over the last two weeks,
how often have you been bothered by feeling down, depressed or hopeless? *


 
Over the last two weeks,
how often have you been bothered by having little interest or pleasure in doing things? *


 
Can someone on our team text you if we have any questions about your survey?

     
 
What is your cell phone number?

 
You have completed the burnout and stress questions. Would you like to continue with the demographic questions?

     
 
Are you an...?


 
Specialty?

 
Practice name?

 
City of practice?

 
State of practice?

 
Practice size (number of full-time physicians)

 
Are you?


 
Practice type?


 
Practice specialty?

 
EHR vendor?

 
Where do you spend the majority of your clinic time?


 
Please tell us the number of years in your current role

 
What is your gender?


 
What is your race?


 
What is your ethnicity?


 
What is your cell number?