RESIDENT BURNOUT IN THE MEDICAL ICU IN AN ACADEMIC TERTIARY CARE CENTER

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: Burnout is a syndrome comprising of emotional exhaustion, depersonalization, and low sense of personal accomplishment. Burnout negatively effects patient care, healthcare systems, and trainee well-being. The prevalence of burnout among providers in the intensive care setting is high, as is the prevalence of burnout among residents in general. However, there is little data on how burnout affects residents as they rotate through the medical intensive care unit (MICU). A better understanding of the state of burnout amongst this specific population is the first step in learning to recognize and prevent MICU resident burnout in the future. METHODS: This study surveyed residents to assess burnout at the end of their MICU rotation at the University of North Carolina Hospital MICU over the course of a 6-month period (October 2020 – March 2021). We assessed the prevalence of burnout using the Maslach Burnout Inventory - Human Services Survey for Medical Personnel (MBI-HSS (MP)). In addition to the MBI-HSS (MP), the survey gathered basic demographic information and assessed how burnout in the MICU compares to other rotations, the perceived drivers of burnout, and ideas regarding its mitigation. Survey data was analyzed using descriptive statistics. RESULTS: The survey was completed by 38 residents (16 females; 22 males; 23 first-year residents; 15 senior residents; 23 internal medicine residents; 15 non-internal medicine residents). 57% of participants felt that there was more burnout in the MICU than other ICU rotations and 75% felt there was more burnout in the MICU than other non-ICU rotations. Prevalence of burnout was: 87% overall, 83% in internal medicine residents, 100% in non-internal medicine residents, 91% in interns, and 80% in senior residents. The factors felt to most contribute to burnout were (1) lack of time to exercise, take care of oneself, and/or engage in enjoyable activities outside of work, (2) conflicting responsibilities between work, home, and family, and (3) time spent on the electronic medical record and documenting. These same three factors were rated as being more of an issue in the MICU in comparison to other rotations. The interventions that the majority of residents felt to have the highest likelihood of decreasing burnout were (1) debriefing after adverse patient outcomes, (2) having clear expectations set at the beginning of the rotation, (3) having formal feedback one week into the rotation, (4) training on how to deal with difficult patients, and (5) increased support from advanced practice practitioners and/or scribes. CONCLUSIONS: This study confirms that burnout in residents rotating through the MICU is high and that there is a higher degree of burnout in the MICU compared to other rotations. First-year residents and non-internal medicine residents may be even more at risk of burnout during their MICU rotation. CLINICAL IMPLICATIONS: The study offers several factors contributing to burnout and potential interventions. Burnout has been linked to shorter life expectancy, problematic substance use, depression, suicide, poor patient care, and unprofessional behavior. Therefore, decreasing burnout in residents rotating through the MICU could potentially improve patient care/outcomes and trainee well-being. Further studies in this area are needed, including studies assessing efficacy of potential interventions, but this study offers a start. DISCLOSURES: No relevant relationships by Jean-Luc Banks, source=Web Response No relevant relationships by Jean Cadigan, source=Web Response No relevant relationships by Arlene Davis, source=Web Response no disclosure submitted for Diya Jost; No relevant relationships by Christina Orantes, source=Web Response No relevant relationships by Hitesh Patel, source=Web Response No relevant relationships by Kunal Patel, source=Web Response