Gomez Sofia, Anderson Brian J, Yu Hyunmin, Gutsche Jacob, Jablonski Juliane, Martin Niels, Kerlin Meeta Prasad, Mikkelsen Mark E
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Crit Care Explor. 2020 Oct 21;2(10):e0233. doi: 10.1097/CCE.0000000000000233. eCollection 2020 Oct.
Examine well-being, measured as burnout and professional fulfillment, across critical care healthcare professionals, ICUs, and hospitals within a health system; examine the impact of the coronavirus disease 2019 pandemic.
To complement a longitudinal survey administered to medical critical care physicians at the end of an ICU rotation, which began in May 2018, we conducted a cross-sectional survey among critical care professionals across four hospitals in December 2018 to January 2019. We report the results of the cross-sectional survey and, to examine the impact of the coronavirus disease 2019 pandemic, the longitudinal survey results from July 2019 to May 2020.
Academic medical center.
Four-hundred eighty-one critical care professionals, including 353 critical care nurses, 58 advanced practice providers, 57 physicians, and 13 pharmacists, participated in the cross-sectional survey; 15 medical critical care physicians participated in the longitudinal survey through the coronavirus disease 2019 pandemic.
None.
Burnout was present in 50% of ICU clinicians, ranging from 42% for critical care physicians to 55% for advanced practice providers. Professional fulfillment was less common at 37%, with significant variability across provider ( = 0.04), with a low of 23% among critical care pharmacists and a high of 53% among physicians. Well-being varied significantly at the hospital and ICU level. Workload and job demand were identified as drivers of burnout and meaning in work, culture and values of work community, control and flexibility, and social support and community at work were each identified as drivers of well-being. Between July 2019 and March 2020, burnout and professional fulfillment were present in 35% (15/43) and 58% (25/43) of medical critical care physician responses, respectively. In comparison, during the coronavirus disease 2019 pandemic, burnout and professional fulfillment were present in 57% (12/21) and 38% (8/21), respectively.
Burnout was common across roles, yet differed across ICUs and hospitals. Professional fulfillment varied by provider role. We identified potentially modifiable factors related to clinician well-being that can inform organizational strategies at the ICU and hospital level. Longitudinal studies, designed to assess the long-term impact of the coronavirus disease 2019 pandemic on the well-being of the critical care workforce, are urgently needed.
在一个医疗系统内，对重症监护医疗专业人员、重症监护病房（ICU）和医院的幸福感进行评估，评估指标为职业倦怠和职业成就感；研究2019年冠状病毒病疫情的影响。
为补充2018年5月开始的对重症监护内科医生在ICU轮转结束时进行的纵向调查，我们于2018年12月至2019年1月在四家医院的重症监护专业人员中开展了一项横断面调查。我们报告横断面调查结果，并为研究2019年冠状病毒病疫情的影响，报告2019年7月至2020年5月的纵向调查结果。
学术医疗中心。
481名重症监护专业人员参与了横断面调查，其中包括353名重症监护护士、58名高级执业人员、57名医生和13名药剂师；15名重症监护内科医生在2019年冠状病毒病疫情期间参与了纵向调查。
无。
50%的ICU临床医生存在职业倦怠，重症监护医生的职业倦怠率为42%，高级执业人员为55%。职业成就感的比例较低，为37%，不同医疗人员之间存在显著差异（P = 0.04），重症监护药剂师中职业成就感比例低至23%，医生中高至53%。幸福感在医院和ICU层面存在显著差异。工作量和工作需求被确定为职业倦怠的驱动因素，工作意义、工作群体的文化和价值观、控制权和灵活性以及工作中的社会支持和群体被分别确定为幸福感的驱动因素。2019年7月至2020年3月期间，重症监护内科医生回复中职业倦怠和职业成就感的比例分别为35%（15/43）和58%（25/43）。相比之下，在2019年冠状病毒病疫情期间，职业倦怠和职业成就感的比例分别为57%（12/21）和38%（8/21）。
职业倦怠在各角色中普遍存在，但在不同的ICU和医院有所不同。职业成就感因医疗人员角色而异。我们确定了与临床医生幸福感相关的潜在可改变因素，可为ICU和医院层面的组织策略提供参考。迫切需要开展纵向研究，以评估2019年冠状病毒病疫情对重症监护医护人员幸福感的长期影响。
