(881) Organizational Systems That Impact Provider Well-Being in Intensive Care Units Versus Others

Introduction: Wellbeing and resiliency are essential to the future of medicine and a focus on workforce systems is important to address the root causes of burnout. Workplace systems not only affect individual productivity and mental wellbeing, but also impact patients. We hypothesized that stressors in intensive care unit (ICU) clinicians (nurses and physicians or advanced practice providers) would differ from their counterparts in hospital floor or emergency department units.

Methods: 16 one-hour focus groups were conducted with 96 attendings, nurses, and residents. Areas of specialty included pediatric hospital medicine, emergency medicine, mother baby, adult cardiovascular step-down, surgical trauma critical care, and pediatric critical care. A direct content analysis approach was employed to analyze responses. Data was coded and analyzed by three independent researchers into five groups including organizational support, changes to work environment, mental health and wellbeing access barriers, mental health and wellbeing solutions, and other.

Results: For this evaluation, resident data was withheld due to their work in multiple areas and confounding effects. There were common themes regarding organizational barriers (impact of bed management and staffing) in addition to lack of knowledge of mental health and wellbeing resources. However, ICU team members shared more concerns regarding time to access resources, and ICU nurses also described pay discrepancy. ICU providers shared more issues around work design barriers regarding facility resources and work optimization than other units.

Regarding wellbeing strategies, ICU team members focused on resiliency building and debriefing while the other units focused on appreciation and being valued. Overall, there was less discussion of impact of burnout in ICUs compared to emergency and floor teams.

Conclusions: ICU team members had unique contributors to organizational wellbeing and focused more on access to resources. The most impactful result was the stronger focus on resiliency and debriefing support in ICU team members versus the non-critical care units. This research supports the need for ICU leaders to encourage resiliency building and debriefing to create a culture of wellbeing to optimize employee retention, engagement, and patient outcomes.