Jochen Profit1, Paul J Sharek2, Amber B Amspoker3, Mark A Kowalkowski4, Courtney C Nisbet5, Eric J Thomas6, Whitney A Chadwick7, J Bryan Sexton8. 1. Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, USA California Perinatal Quality Care Collaborative, Palo Alto, USA. 2. California Perinatal Quality Care Collaborative, Palo Alto, USA Center for Quality and Clinical Effectiveness, Lucile Packard Children's Hospital, Palo Alto, USA Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, USA. 3. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, USA Health Policy and Quality Program, Houston Veterans Affairs (VA) Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, USA. 4. Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina, USA. 5. California Perinatal Quality Care Collaborative, Palo Alto, USA Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, USA. 6. University of Texas at Houston-Memorial Hermann Center for Healthcare Quality and Safety, University of Texas Medical School, Houston, USA. 7. Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, USA. 8. Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, USA Duke Patient Safety Center, Duke University Health System, Durham, USA.
Abstract
BACKGROUND: Burnout is widespread among healthcare providers and is associated with adverse safety behaviours, operational and clinical outcomes. Little is known with regard to the explanatory links between burnout and these adverse outcomes. OBJECTIVES: (1) Test the psychometric properties of a brief four-item burnout scale, (2) Provide neonatal intensive care unit (NICU) burnout and resilience benchmarking data across different units and caregiver types, (3) Examine the relationships between caregiver burnout and patient safety culture. RESEARCH DESIGN: Cross-sectional survey study. SUBJECTS: Nurses, nurse practitioners, respiratory care providers and physicians in 44 NICUs. MEASURES: Caregiver assessments of burnout and safety culture. RESULTS: Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. The percentage of respondents in each NICU reporting burnout ranged from 7.5% to 54.4% (mean=25.9%, SD=10.8). The four-item burnout scale was reliable (α=0.85) and appropriate for aggregation (intra-class correlation coefficient-2=0.95). Burnout varied significantly between NICUs, p<0.0001, but was less prevalent in physicians (mean=15.1%, SD=19.6) compared with non-physicians (mean=26.9%, SD=11.4, p=0.0004). NICUs with more burnout had lower teamwork climate (r=-0.48, p=0.001), safety climate (r=-0.40, p=0.01), job satisfaction (r=-0.64, p<0.0001), perceptions of management (r=-0.50, p=0.0006) and working conditions (r=-0.45, p=0.002). CONCLUSIONS: NICU caregiver burnout appears to have 'climate-like' features, is prevalent, and associated with lower perceptions of patient safety culture. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND: Burnout is widespread among healthcare providers and is associated with adverse safety behaviours, operational and clinical outcomes. Little is known with regard to the explanatory links between burnout and these adverse outcomes. OBJECTIVES: (1) Test the psychometric properties of a brief four-item burnout scale, (2) Provide neonatal intensive care unit (NICU) burnout and resilience benchmarking data across different units and caregiver types, (3) Examine the relationships between caregiver burnout and patient safety culture. RESEARCH DESIGN: Cross-sectional survey study. SUBJECTS: Nurses, nurse practitioners, respiratory care providers and physicians in 44 NICUs. MEASURES: Caregiver assessments of burnout and safety culture. RESULTS: Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. The percentage of respondents in each NICU reporting burnout ranged from 7.5% to 54.4% (mean=25.9%, SD=10.8). The four-item burnout scale was reliable (α=0.85) and appropriate for aggregation (intra-class correlation coefficient-2=0.95). Burnout varied significantly between NICUs, p<0.0001, but was less prevalent in physicians (mean=15.1%, SD=19.6) compared with non-physicians (mean=26.9%, SD=11.4, p=0.0004). NICUs with more burnout had lower teamwork climate (r=-0.48, p=0.001), safety climate (r=-0.40, p=0.01), job satisfaction (r=-0.64, p<0.0001), perceptions of management (r=-0.50, p=0.0006) and working conditions (r=-0.45, p=0.002). CONCLUSIONS: NICU caregiver burnout appears to have 'climate-like' features, is prevalent, and associated with lower perceptions of patient safety culture. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
Health services research; Healthcare quality improvement; Safety culture
Authors: Tait D Shanafelt; Colin P West; Jeff A Sloan; Paul J Novotny; Greg A Poland; Ron Menaker; Teresa A Rummans; Lotte N Dyrbye Journal: Arch Intern Med Date: 2009-05-25
Authors: J T Prins; F M M A van der Heijden; J E H M Hoekstra-Weebers; A B Bakker; H B M van de Wiel; B Jacobs; S M Gazendam-Donofrio Journal: Psychol Health Med Date: 2009-12 Impact factor: 2.423
Authors: William O Cooper; Oscar Guillamondegui; O Joe Hines; C Scott Hultman; Rachel R Kelz; Perry Shen; David A Spain; John F Sweeney; Ilene N Moore; Joseph Hopkins; Ira R Horowitz; Russell M Howerton; J Wayne Meredith; Nathan O Spell; Patricia Sullivan; Henry J Domenico; James W Pichert; Thomas F Catron; Lynn E Webb; Roger R Dmochowski; Jan Karrass; Gerald B Hickson Journal: JAMA Surg Date: 2017-06-01 Impact factor: 14.766
Authors: James M Hoffman; Nicholas J Keeling; Christopher B Forrest; Heather L Tubbs-Cooley; Erin Moore; Emily Oehler; Stephanie Wilson; Elisabeth Schainker; Kathleen E Walsh Journal: Pediatrics Date: 2019-02 Impact factor: 7.124
Authors: Daniel S Tawfik; John Bryan Sexton; Kathryn C Adair; Heather C Kaplan; Jochen Profit Journal: Clin Perinatol Date: 2017-07-08 Impact factor: 3.430
Authors: Daniel S Tawfik; Ciaran S Phibbs; J Bryan Sexton; Peiyi Kan; Paul J Sharek; Courtney C Nisbet; Joseph Rigdon; Mickey Trockel; Jochen Profit Journal: Pediatrics Date: 2017-04-18 Impact factor: 7.124
Authors: Daniel S Tawfik; Annette Scheid; Jochen Profit; Tait Shanafelt; Mickey Trockel; Kathryn C Adair; J Bryan Sexton; John P A Ioannidis Journal: Ann Intern Med Date: 2019-10-08 Impact factor: 25.391
Authors: Daniel S Tawfik; Jochen Profit; Timothy I Morgenthaler; Daniel V Satele; Christine A Sinsky; Liselotte N Dyrbye; Michael A Tutty; Colin P West; Tait D Shanafelt Journal: Mayo Clin Proc Date: 2018-07-09 Impact factor: 7.616
Authors: J Bryan Sexton; Paul J Sharek; Eric J Thomas; Jeffrey B Gould; Courtney C Nisbet; Amber B Amspoker; Mark A Kowalkowski; René Schwendimann; Jochen Profit Journal: BMJ Qual Saf Date: 2014-05-13 Impact factor: 7.035