An Official Critical Care Societies Collaborative Statement: Burnout Syndrome in Critical Care Healthcare Professionals: A Call for Action*

Moss, Marc; Good, Vicki S.; Gozal, David; Kleinpell, Ruth M.; Sessler, Curtis N.

doi:10.1097/ccm.0000000000001885

Cited by 157 publications

(77 citation statements)

References 55 publications

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“…Burnout syndrome, characterized by exhaustion, depersonalization, and reduced personal accomplishment (6), appears to be increasing among physicians generally (7) and has been found to be present in almost half of intensivists (20). Burnout may lead to post-traumatic stress disorder, alcohol abuse, or suicidal ideation (6). Burnout may also contribute to intensivists leaving the profession or poorer work performance (6).…”

Section: Discussionmentioning

confidence: 99%

“…Burnout may lead to post-traumatic stress disorder, alcohol abuse, or suicidal ideation (6). Burnout may also contribute to intensivists leaving the profession or poorer work performance (6). The Shared Service schedule may promote improved work-life balance by increasing amount of time between clinical duties and number of weekends off, both of which have been associated with decreased burnout and depression (12, 20, 21).…”

Section: Discussionmentioning

confidence: 99%

“…Weekend calls increase the total number of weekends required to be at the hospital and away from personal interests. Burnout has been increasing among intensivists and has been receiving increasing attention, as evidenced by the recent joint statement of the Critical Care Societies Collaborative (6). Workload has been identified as a primary risk factor for burnout (6).…”

Section: Introductionmentioning

confidence: 99%

“…Burnout has been increasing among intensivists and has been receiving increasing attention, as evidenced by the recent joint statement of the Critical Care Societies Collaborative (6). Workload has been identified as a primary risk factor for burnout (6). Unfortunately, little research has been done on ways to decrease or mitigate the effect of time spent in the hospital and on how to optimize scheduling for 24/7 in-house intensivist coverage (7, 8).…”

Section: Introductionmentioning

confidence: 99%

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Simulation of a Novel Schedule for Intensivist Staffing to Improve Continuity of Patient Care and Reduce Physician Burnout

Geva¹,

Landrigan²,

Velden

et al. 2017

Critical Care Medicine

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Objective Despite widespread adoption of in-house call for ICU attendings, there is a paucity of research on optimal scheduling of intensivists to provide continuous on-site coverage. Overnight call duties have traditionally been added onto 7 days of continuous daytime clinical service. We designed an alternative ICU staffing model to increase continuity of attending physician care for patients while also decreasing interruptions to attendings’ non-clinical weeks. Design Computer-based simulation of a one-year schedule. Setting A simulated ICU divided into 2 daytime teams each covered by a different attending and both covered by 1 overnight on-call attending. Subjects Simulated patients were randomly admitted on different service days to assess continuity of care. Interventions A Shared Service schedule was compared to a standard 7 Days On schedule. For the 7 Days On schedule, an attending covered a team for 7 consecutive days and off-service attendings cross-covered each night. For the Shared Schedule, 4 attendings shared the majority of daytime and nighttime service for 2 teams over 2 weeks, with recovery periods built into the scheduled service time. Measurements and Main Results Continuity of care as measured by the Continuity of Attending Physician Index (CAPI) increased by 9% with the Shared Schedule. Annually, the Shared Service Schedule was predicted to increase free weekends by 3.4 full weekends and 1.3 weekends with either Saturday or Sunday off. Full weeks without clinical obligations increased by 4 weeks. Mean time between clinical obligations increased by 5.8 days. Conclusions A Shared Service schedule is predicted to improve continuity of care while increasing free weekends and continuity of uninterrupted non-clinical weeks for attendings. Computer-based simulation allows assessment of benefits and tradeoffs of the alternative schedule without disturbing existing clinical systems.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Simulation of a Novel Schedule for Intensivist Staffing to Improve Continuity of Patient Care and Reduce Physician Burnout

Geva¹,

Landrigan²,

Velden

et al. 2017

Critical Care Medicine

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“…Moral distress is especially common in critical care healthcare professionals, occurring in up to 80 % of critical care nurses [5]. In general, nurses are more likely to develop moral distress than physicians due to the nurse’s perceived inability to make decisions and their feeling of being “voiceless” during morally complex conversations [4, 6]. …”

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confidence: 99%

Moral distress in ICU nurses

2016

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Association of Burnout With Depression and Anxiety in Critical Care Clinicians in Brazil

et al. 2020

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IMPORTANCEIt is unclear whether burnout, anxiety, and depression constitute the same or different constructs. Better understanding of these constructs is important for diagnosis and treatment for intensive care unit (ICU) clinicians. OBJECTIVE To determine the associations and distinctiveness of burnout, depression, and anxiety in a sample of ICU clinicians. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used baseline data from the ICU Visits Study, a cluster-randomized crossover clinical trial conducted from April 2017 to July 2018 in 36 mixed public and private nonprofit ICUs in Brazil. ICU clinicians, including day-shift physicians, nurses, nurse technicians, and physiotherapists working in an ICU at least 20 hours per week, were enrolled. Data were analyzed from December 27, 2019, to October 10, 2020. MAIN OUTCOMES AND MEASURES The main outcome measures were burnout, depression, and anxiety measured with the Maslach Burnout Inventory (MBI; range, 0-6, with high scores indicating more burnout) and the Hospital Depression and Anxiety Scale (HADS; range, 0-3, with higher scores indicating more depression or anxiety). Internal consistencies were satisfactory. RESULTS The total sample included 715 ICU clinicians (median [interquartile range] age, 34.8 [30.2-39.3] years; 520 [72.7%] women), including 96 physicians (13.4%), 159 nurses (22.2%), 358 nurse technicians (50.1%), and 102 physiotherapists (14.3%). Clinicians reported low levels of emotional exhaustion (mean [SD] score, 1.84 [1.18]), depersonalization (mean [SD] score, 0.98 [1.03]), and personal accomplishment (mean [SD] score, 5.05 [0.87]) on the MBI, and similarly low levels of depression (mean [SD] score, 0.54 [0.40]) and anxiety (mean [SD] score, 0.70 [0.45]) on the HADS.Confirmatory factor analyses consistently showed improved fit separating latent burnout dimensions from depression and anxiety. An exploratory graph analysis combining gaussian graphical model with clustering algorithms for weighted networks suggested 3 clusters, with distinct burnout, anxiety, and depression clusters. This structure was confirmed using a bootstrap with 1000 random samples, in which the 3-cluster solution emerged in 625 samples (62.5%). Both latent variable loadings and network statistics suggested 3 key indicators (ie, feeling burned out from work, worrying thoughts, and reverse-scored reporting feeling cheerful) that can be used for short screening instruments. CONCLUSIONS AND RELEVANCEThese findings suggest that burnout and clinical symptoms of depression and anxiety were empirically distinct in a large sample of ICU clinicians, highlighting the importance of screening for burnout and clinical symptoms to allow fast access to adequate support and treatment in health professionals at high risk of burnout.

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An Official Critical Care Societies Collaborative Statement: Burnout Syndrome in Critical Care Healthcare Professionals: A Call for Action*

Cited by 157 publications

References 55 publications

Simulation of a Novel Schedule for Intensivist Staffing to Improve Continuity of Patient Care and Reduce Physician Burnout

Simulation of a Novel Schedule for Intensivist Staffing to Improve Continuity of Patient Care and Reduce Physician Burnout

Moral distress in ICU nurses

Association of Burnout With Depression and Anxiety in Critical Care Clinicians in Brazil

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