The objective of the research study is to provide a summary of the results obtained from a National Summit and survey about the wellness, prevention, and management of burnout in the intensive care unit (ICU). The authors go further to discuss the information provided by the experts and describe the recommendations based on the findings. The research study was collected through a literature review and descriptive survey. The data for the survey was collected through the Research Electronic Data Capture (REDCap). The Critical Care Societies Collaborative (CCSC) desired to address burnout amongst critical care specialists on data synthesis.
The organization supported the National Summit on Prevention and Management of Burnout in the ICU. Up to 55 professionals were invited to participate in the forum. They were drawn from different areas of specialization, including sociology, psychology, psychotherapy, meditation, perversity prevention, ethics, integrative medicine, bereavement support, palliative care, and mindfulness-based stress management. They were divided into different groups to discuss and help identify factors that influence burnout among specialists working in the ICU. They were also required to discuss the importance of managerial and personal interventions. The researchers sent a descriptive survey to the specialists through email and newsletter blasts. They were required to evaluate different strategies that organizations may well apply to address burnout.
CCSC received feedback from 680 members, including nurses, doctors, therapists, and pharmacologists, among others. The conclusion indicates that experts who attended the Summit recognized raising responsiveness among critical care clinicians and essential stakeholders. They also emphasized the need to support changes at work, promoting a better working environment. Lastly, they raised the need to support research studies to discover practical approaches further to address, moderate, and avoid burnout. The critical care clinicians reported on the measures being applied at the hospital and unit level to enhance resilience and support burnout prevention.
The effort was not reported across all organizations, with some colleagues reporting to have experienced burnout. The outcome emphasizes the need to convey and apply resilient procedures and policies to address burnout among critical care clinicians.
The rationale for the review was informed by the urge to raise awareness and attentiveness in burnout syndrome (BOS) amongst healthcare providers. The objective of the research study is to find initiatives that promote clinician wellbeing and further appreciate the value of identifying, addressing, moderating, and avoiding burnout. The study was informed by the weight that burnout is placing on healthcare personnel and the patients. The research participants include the critical care clinicians, former ICU patients, and graduate nursing, psychology and pharmacy students.
The research study does not have a review protocol; it was based on expert opinion and a descriptive survey. The eligible criteria;
- Experts from the following areas of specialization; psychology, psychiatry, ethics, sociology, palliative care, meditation, employee assistance, bereavement support, occupational medicine, suicide prevention, social work, sleep medicine, nursing, integrative medicine, mindfulness-based stress reduction, and research;
- Former ICU patients;
- Graduate students in pharmacy, psychology, and nursing to provide diversity and reduce the risk for bias;
- National groups of interest, including the National Patient Safety Foundation, NAM, American Hospital Association, the Joint Commission, Shambhala Meditation Center, and Institute for Healthcare Improvement, ACGME, together with the American Foundation for Suicide Prevention.
The experts were categorized into five groups that formed the variables for the study. These are;
- Factors impelling burnout in ICU specialists;
- Ascertaining burnout in ICU experts;
- The significance of managerial involvement in addressing burnout;
- The value of personal interposition in addressing burnout;
- Promoting the research agenda.
To build on the information gathered during the Summit, the research sent blast email and newsletter notifications to the members of the CCSC organizations between September and December 2018. The researchers collected the data anonymously through the Research Electronic Data Capture (project-redcap.org). The survey was classified under the exempt IRB review grade. It comprised six questions designed to evaluate the resources and measures being applied at the managerial and unit levels. Some of the criteria considered include; the presence of a chief wellness officer or related role, wellness team, and the standing of the employing organization on matters concerning the promotion of the wellbeing of clinicians and moderating burnout.
Out of these discussions, the respondents acknowledged that specific measures to address the demanding ICU setup are required and should be prioritized in moderating burnout in ICU clinicians. The efforts involve both organizational and individual measures as indicated in table 1 below;
Table 1; Resources and Targeting Measures Being Implemented.
|Resources and Measures||Number||Percentage|
|Healthy food choice on campus||331||55.8 %|
|On-campus exercise / gym facilities||263||44.5 %|
|Ability to take personal / respite days||148||25 %|
|Interpersonal / communication training||131||22.1 %|
|Limit the number of maximum days to work consecutively in the ICU||114||19.2 %|
|Respite room||91||15.3 %|
|Staff support groups||.66||11.1 %|
|ICU team building training||63||10.6 %|
|Yoga class||115||19.4 %|
|Mindfulness – based stress reduction class||107||18 %|
|Meditation class||58||9.8 %|
The discussion also covered the importance of different interventions and the mandate organizations need to fulfill to have healthy working surroundings. The results established that managerial, as well as personal responsibility, are desirable to moderate BOS successfully. In addition, the discussion pointed to the need for greater awareness for organizations to be flexible and support healthy working surroundings. The responses established that more effort is required to facilitate the application of supporting measures to the clinicians. The experts identified areas for further research with effects for ICU clinicians.
Out of the survey blasts sent to the members of the CCSC organizations, 680 responses were received from different critical care clinicians as indicated in table 2 below;
Table 2; Survey Responses from the Critical Care Clinicians.
|Clinicians||Number of responses||Percentage of responses|
|Advanced practice registered nurses||10||6.3 %|
|Physician assistants||10||1.5 %|
|Others (respiratory therapists, dieticians, and ICU nurse administrators)||14||2.1 %|
In addition, the results indicated that 287 (42.3%) reported having either a chief wellness officer or a wellness committee, 156 (23.2%) reported having a person tasked with a similar role in the organization. The respondents also reported having a number of organizational resources, as indicated in table 3 below;
Table 3; Organizational Resources.
|Resource||Number of responses||Percentage of responses|
|Healthy meals of choice on campus||331||55.8 %|
|On-campus exercise / gym facilities||264||44.5 %|
|Interpersonal / communication training||131||22.1 %|
|Ability to take personal/respite days||148||25 %|
|Mindfulness based stress reduction classes||107||18.0 %|
|Staff support groups||66||11.1 %|
The results on the observed status attached to promoting the clinician’s wellbeing and moderation of burnout were varied among respondents. 74 (10.9%) of the respondents reported “highly important,” 215 (31.7%) said “important,” 264 (38.9%) reported “not important,” and 126 (18.6%) wrote, “not at all important.”
The respondents reported on several other additional managerial or individual tactics to encourage wellbeing and resiliency. These include; unit-based holiday festivities, counseling gatherings under challenging moments such as death, taking break time, employee appreciation doings, and a unit-based appreciation and retention board, among others. They also reported on additional interventions that support a better work environment. They include; arranging cumbersome sequential ICU weeks or nights, not overstraining ICU clinicians, improving the working environment, work balance, and a caring administration (Kleinpell et al., 2020).
They also indicated that although burnout is addressed across many meetings and institutions, there is low attention to the resolution of cases or improving working conditions. Others feel the institutional awareness is still low, others blame their profession, while others think there are inadequate resources to address burnout of clinicians or prevent it. The respondents reported that quite a few organizations had not implemented any measure to address clinician burnout, the most critical acute care treatment issue.
The National Summit established critical insights on the topic of clinician burnout. There is the need to promote attention to the wellness of essential clinicians of care and main stakeholders, advocating for improved working conditions, and supporting research on different interventions to address, moderate, and avoid burnout. In general, the findings indicated that organizations could reduce burnout through organizational interventions, such as team building, proper staffing, meaningful appreciation, or varying work timetables, and individual interventions, such as training on reducing stress, recreation tactics, reflection, exercise, eating healthy foods, and adequate sleep.
Although the sample size relied upon in the survey was small, the results pointed to the need to implement different measures at the hospital and unit levels to support clinicians’ wellbeing and prevent burnout. Kleinpell et al. (2020) established that it is essential to implement preventive measures and identify necessary interventions at the organizational and individual levels, addressing broad administrative glitches. Some of the actions identified include encouraging healthy eating and exercise, allowing respite days, streamlining workflow in the ICU through flexible timetables and self-scheduling, regulating the maximum number of days to work sequentially in the ICU, and self-care interventions, such as going on vacations, team building activities, and respite time.
Furthermore, most (57%) of the responses revealed that organizations did not attach the appropriate weight on the importance of supporting wellness and moderating critical care clinician’s burnout. A number of the respondents said that no measures were being used in their organizations, exposing their coworkers to burnout. Therefore, there is the need to convey and apply measures to address burnout amongst critical care clinicians and support a strong work environment. ICU care entails providing medical attention to critically ill patients; hence the major need to address and avoid burnout in the ICU.
The National Summit and survey were supported by the Critical Care Societies Collaborative (CCSC). The CCSC facilitated the National Summit by convening the participants to discuss the topic on ICU clinician’s burnout.
Kleinpell, R., Moss, M., Good, V. S., Gozal, D., & Sessler, C. N. (2020). The critical nature of addressing burnout prevention. Critical Care Medicine, 48(2), 249-253. Web.