Factors Associated With Professional Fulfillment, Work Exhaustion, and Job Turnover Intention Among Infectious Diseases Pharmacists

BACKGROUND: Infectious diseases (ID) pharmacists practice in an important therapeutic area and hold critical roles including leading antimicrobial stewardship (AMS) programs and participating in ID clinical services. High United States pharmacist burnout prevalence, before and after the coronavirus disease 2019 (COVID-19) pandemic, ensures pharmacist shortages into the foreseeable future, prioritizing a need to protect ID pharmacist well-being. Accordingly, work exhaustion (exhaustion), low professional fulfillment (fulfillment), and high job turnover intention (turnover) are particularly concerning. This study evaluated associations between work system characteristics and fulfillment, exhaustion, and turnover among ID/AMS pharmacists. METHODS: The Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 Model was used to guide classification and organization of items from a recent national ID/AMS pharmacist survey to identify work system characteristics associated with exhaustion, fulfillment, and turnover. The sample consisted of 484 licensed US pharmacists reporting involvement in formal or informal ID and/or AMS responsibilities. Multivariate binomial logistic regressions modeled the association of the independent variable domains on each outcome. RESULTS: The proportion of respondents reporting high levels of fulfillment, exhaustion, or turnover was 42%, 24%, and 15%, respectively. High autonomy predicted high fulfillment (odds ratio [OR] = 22.741, p = 0.003) and low turnover (OR = 0.202; p < 0.001). A supervisor who listened to respondent concerns predicted low exhaustion (OR = 0.259, p < 0.001) and high fulfillment (OR = 3.972, p < 0.001). Adequate job resources predicted low exhaustion (OR = 0.200, p < 0.001) and high fulfillment (OR = 3.238, p < 0.001). Additionally, being asked to do activities beyond hiring expectations predicted high exhaustion (OR = 2.340, p = 0.017), while organizational strategies to improve well-being predicted low turnover (OR = 0.315, p = 0.014). CONCLUSIONS: The findings validate the need to examine work system characteristics influencing pharmacists' perceptions about their work life. Strategically, organizations should ensure that ID/AMS programs are resourced appropriately, facilitate pharmacist autonomy, improve pharmacist-leader communication, and manage ID/AMS pharmacists' workload. Improving these work system aspects can facilitate well-being and enable ID/AMS pharmacists to successfully carry out their roles.