Battling Intensivist Burnout: A Role for Workload Management

Burnout syndrome is an increasingly common phenomenon that threatens our critical care workforce and the well-being of its members. Burnout syndrome can be conceived of as a workforce manifestation of chronic workload and workforce capacity imbalance. This study explores the role of workload management tools that can address workload as a complement to the resilience-based countermeasures that seek to increase worker capacity. We were able to use step-wise increments in the volume of documentation-related tasks that occurred at the time of electronic health record (EHR) implementation to investigate the relation of workload and burnout. Specialty-specific increases in the prevalence of self-reported burnout during the era of EHR adoption were compared with increases of the length of documentation created by the corresponding specialists observed prior to and following EHR implementation; a robust direct association was reported. To connect ICU workload to burnout, the number of tasks performed was extracted from the EHR, and we measured the average time that our ICU team members required to complete these tasks. Our ICU workforce efficiency was calculated as the ratio of mandatory task time to scheduled time. Comparing this ratio vs a well-established industrial standard for equipment efficiency made us realize that our average workload seemed excessive and placed our staff at risk of burnout syndrome. It is difficult to conceive that our resilience-based countermeasures to prevent and treat burnout would not be more effective when combined with measures that reduce the time our staff members spend on mandatory ICU tasks.