{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T08:49:07Z","timestamp":1774946947310,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,3,10]],"date-time":"2016-03-10T00:00:00Z","timestamp":1457568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To develop a valid instrument to assess morale and explore the relationship between morale and intent to leave employment due to unhappiness.<\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p>An expert panel identified 46 drivers of hospitalist morale. In May 2009, responders of our single\u2010site pilot survey rated each driver in terms of current contentment and importance to their morale. With exploratory factor analysis, a 28\u2010item\/7\u2010factor instrument emerged. In May 2011, the refined scale was distributed to 108 hospitalists from 2 academic and 3 community hospitals. Confirmatory factor analysis (CFA) was used for internal validation and refinement of the Hospitalist Morale Index. Importance ratings and contentment assessments were used to generate item scores, which were then combined to generate factor scores and personal morale scores. Results were used to validate the instrument and evaluate the relationship between hospitalist morale and intent to leave due to unhappiness.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The 2011 response rate was 86%. The final CFA resulted in a 5\u2010factor and 5\u2013stand\u2010alone\u2010item model. Personal morale scores were normally distributed (mean = 2.79, standard deviation = 0.58). For every categorical increase on a global question that assessed overall morale, personal morale scores rose 0.23 points (<jats:italic>P<\/jats:italic> &lt; 0.001). Each 1\u2010point increase in personal morale score was associated with an 85% decrease (odds ratio: 0.15, 95% confidence interval: 0.05\u20100.41, <jats:italic>P<\/jats:italic> &lt; 0.001) in the odds of intending to leave because of unhappiness.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>The Hospitalist Morale Index is a validated instrument that evaluates hospitalist morale across multiple dimensions of morale. The Hospitalist Morale Index may help program leaders monitor morale and develop customized and effective retention strategies. <jats:italic>Journal of Hospital Medicine<\/jats:italic> 2016;11:425\u2013431. \u00a9 2016 Society of Hospital Medicine<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.2543","type":"journal-article","created":{"date-parts":[[2016,3,12]],"date-time":"2016-03-12T13:26:21Z","timestamp":1457789181000},"page":"425-431","source":"Crossref","is-referenced-by-count":12,"title":["Introducing the Hospitalist Morale Index: A new tool that may be relevant for improving provider retention"],"prefix":"10.1002","volume":"11","author":[{"given":"Shalini","family":"Chandra","sequence":"first","affiliation":[{"name":"Division of Hospital Medicine Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott M.","family":"Wright","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Ghazarian","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Nursing Department of Community and Public Health Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George M.","family":"Kargul","sequence":"additional","affiliation":[{"name":"Virtua Health Hospitalists Voorhees New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric E.","family":"Howell","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,10]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"2014 State of Hospital Medicine Report","year":"2014"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/106286060401900203"},{"issue":"1","key":"e_1_2_6_4_1","first-page":"75","article-title":"Physician retention plans help reduce costs and optimize revenues","volume":"52","author":"Scott K","year":"1998","journal-title":"Healthc Financ Manage."},{"key":"e_1_2_6_5_1","unstructured":"SHM Career Satisfaction Task Force.A Challenge for a New Specialty: A White Paper on Hospitalist Career Satisfaction.; 2006. 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