Shorter ICU Rotations Cut Physician Burnout
TUESDAY, July 2, 2019 -- Shorter rotations in intensive care units can mitigate burnout among physicians, according to a study published online June 25 in the American Journal of Respiratory and Critical Care Medicine.
Mark E. Mikkelsen, M.D., from the University of Pennsylvania in Philadelphia, and colleagues implemented an automated REDCap survey to measure intensivist well-being upon completion of four clinical rotations that varied in structure, staffing, and nighttime workload at two hospitals within Penn Medicine. During a pilot test in the medical intensive care unit (MICU), intensivists had the option to attend for the traditional 14 days or coordinate schedule changes to limit rotations to seven days. Analysis was based upon 128 surveys completed by 29 physicians during rotations from May 2018 through February 2019.
The researchers found that burnout and fulfillment varied by the clinical rotation and length of rotation. Burnout was 61 percent with 47 percent fulfillment rates in a 24-bed MICU staffed by two critical care physicians, fellows, and internal medicine residents versus 24 percent burnout and 76 percent fulfillment rates among the intensivists working a seven-day rotation in an eight-bed unit staffed by one critical care physician and two advanced practice providers. The odds of burnout for 14-day rotations, versus seven days was 5.50. The rate of burnout halfway through a 14-day rotation was similar to that experienced at 14 days.
"Burnout is a threat to the practice of critical care, yet fulfillment is common and organizational strategies targeting the individual and systems level should be implemented and tested to further optimize well-being," the authors write.
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Posted: July 2019