(30 - Saturday) Mitigating burnout in a team of pediatric cardiac critical care advanced practice providers

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Abstract:

Introduction: Burnout syndrome (BOS) negatively impacts health care workers, including advanced practice providers (APPs). Untoward effects include job dissatisfaction, employee turnover, medical errors, organizational costs, and decreased health care quality. Healthcare professionals in critical care areas may be at higher risk for experiencing BOS related to a high acuity work environment, end-of-life situations, physical and emotional demands, and variable workloads and schedules.

Objective: Utilize qualitative information gained from “What Matters to You” interviews and group development theory to create, implement, and measure the impact of an intervention to mitigate burnout and improve team climate among APPs in our cardiac intensive care unit.

Methods: Team building intervention utilizing qualitative data gained from previously conducted “What Matters to You” conversations with Tuckman’s model of group development. The intervention took place in September 2021 and consisted of 5 topics, with didactic learning and team discussions, followed by drafting a team agreement. A pre/post/post-test quasi-experimental design was used to measure the impact of the intervention. Team members completed two questionnaires, Oldenburg Burnout Inventory (OLBI) and Team Climate Inventory (TCI) at the 3-time points surrounding the team building intervention.

Results: 9 of 11 APPs participated in the team-building intervention and drafting of a team agreement. All 9 participants completed the OLBI at the 3-time points. We analyzed survey results using a repeated measure analysis of variance (ANOVA). We found a significant difference in the overall measure of burnout (F statistic = 3.7, p = 0.048). Pairwise comparisons demonstrated a significant decrease in scores from pre-intervention to 1-week post-intervention (mean difference=3.9 points, p = 0.05, 95% CI 0-7.78). While the scores at time point 3 were lower than the scores at time point 1, the difference was not statistically significant. Sub-analysis of disengagement and emotional exhaustion showed no significant difference in scores.
7 of 9 participants completed the TCI at 3 points and were included in the analysis. There was a significant difference in the overall team climate (F statistic = 5.8, p = 0.017). We found a mean decrease in scores between pre-intervention and 1-week post-intervention (mean difference – 26.6 points, p = 0.053, 95% CI: – 53.54, – 0.39). Sub-analysis of the five factors did not show a significant difference in scores.
Anecdotally, the team agreement document has been successfully utilized during conflict to improve team members’ communication.

Conclusions: This study demonstrates that a 1-day team-building event had an immediate but transitory effect on burnout and team climate scores in an existing group of APPs. Developing and adopting a team agreement document may improve team relationships and be a more sustainable intervention.