Burnout prevention in the ICU

Report: Michael Krassnitzer

In intensive medicine, burnout has a major impact on the quality of care. For example, in intensive care units, where the staff suffers burnout, statistics indicate that patients remain longer in an artificial coma than in ICUs that are more or less free of burnout. ‘Obviously, that does not happen consciously,’ says Prof. Wolfgang Lalouschek, Medical Director of The Tree Health Care Centre in Vienna and Director of Medical Coaching, a consulting institute. ‘It’s rather the accumulation of small decisions that lead to measurably poorer outcomes.’

Wolfgang Lalouschek
Wolfgang Lalouschek
Wolfgang Lalouschek
Wolfgang Lalouschek

The clinical staff is particularly at risk of burnout. Several studies conducted in Western countries agree that 20% of physicians and caregivers manifest burnout symptoms and about 50% are considered vulnerable. Personal disposition and the occupational environment influence individual burnout risk. Emotional and physical exhaustion, negative attitudes towards patients and colleagues, as well as reduced physical and mental working capacity, are the major burnout symptoms. In particular, ICU teams come under extreme stress.

Several ICUs within the Vienna Hospital Association (Wiener Krankenanstaltenverbund), one of Europe’s largest healthcare facilities, joined in the pilot project Burnout Prevention in ICUs. Several approaches were developed to reduce burnout risk and increase job satisfaction. Since 40 of the 180 volunteers were physicians, the physician-nurse ratio of the study participants roughly corresponded to the actual ratio in the ICUs.

Initially, burnout-relevant factors among physicians and nurses were surveyed. Then, aiming to develop improvements or solutions, the participants underwent 12-18 months of systemic coaching, either in a team or individually. Systemic coaching is a person-centred and solution-oriented approach that focuses on the professional role. The coach does not offer direct or preconceived solutions, but helps the person being coached to formulate goals and develop solutions.

In the Viennese pilot study, the coaching phase has largely been completed and results are now being evaluated. According to Prof. Lalouschek (who led the project) the coaching showed ‘significant improvements compared to the previous situation, be it in terms of individual self-perception, or organisational and structural issues’.

Quality of work, work and information flows as well as leadership markedly improved during the coaching phase. The rounds focus more on interdisciplinary cooperation and are better planned, information flows are clearly defined and coordination with other wards and departments is improved, Prof. Lalouschek reports, adding: ‘Contradicting orders and information deficits were significantly reduced while the social climate and the subjective quality of work have improved.’

Additional results:
• The expected high level of burnout among ICU staff was confirmed
• However, the clinical staff are highly motivated and dedicated
• The staff are highly prepared to engage in additional training and to initiate improvements
• Ethical considerations continue to play a major role among ICU staff.

‘We saw that the staff is highly motivated to change those things they have the power to change,’ Prof. Lalouschek says. All improvements were realised without additional hiring and or major restructuring, he adds. ‘When people feel they are being listened to, and taken seriously, they are incredibly constructive and committed.’

One drawback: Not all the ICU managers participated in the study and, as the professor emphasises: ‘The room for manoeuvre is much greater when all hierarchy levels are involved’.

08.07.2010

Read all latest stories

Related articles

Photo

Article • Under pressure

Physician burnout cases are rising

Longer hours, more demanding working practices, complex cases and increased administration are taking their toll on physicians as growing numbers, across a range of specialties, report signs of…

Photo

Article • Management

Labs need quality management systems

All laboratories should utilise quality monitoring systems and systematically work through their workflow processes to identify problem areas, according to Lucia Berte, who specialises in quality…

Photo

Article •

Transforming healthcare

Philips at MEDICA: New healthcare solutions developed with users and patients help improve the recovery process and treatment options for patients while supporting medical staff in their work

Related products

DRG Instruments – DRG:Hybrid-XL

Immunochemistry

DRG Instruments – DRG:Hybrid-XL

DRG Instruments GmbH
KABE Labortechnik – Consumables for blood gas analysis

Blood Gases /Electrolytes /Oximetry

KABE Labortechnik – Consumables for blood gas analysis

KABE LABORTECHNIK GmbH
Siemens Healthineers – Luminos Impulse

Flatpanel Fluoro

Siemens Healthineers – Luminos Impulse

Siemens Healthineers
Siemens Healthineers – RapidPoint 500e Blood Gas System

Blood Gases, Electrolytes, Oximetry

Siemens Healthineers – RapidPoint 500e Blood Gas System

Siemens Healthineers
Swissray - Cortex Protection Software

Utilities / Add-ons

Swissray - Cortex Protection Software

Swissray Technologies AG
Subscribe to Newsletter