A roadmap for critical care societies to address burnout among health care professionals

A new paper published online in the Annals of the American Thoracic Society provides a roadmap that critical care clinicians' professional societies can use to address burnout. While strongly needed prior to the COVID-19 pandemic, the roadmap has taken on even greater urgency due to reports of increasing pandemic-related burnout.

In "Professional Societies' Role in Addressing Member Burnout and Promoting Well-Being," Seppo T. Rinne, MD, PhD, of The Pulmonary Center, Boston University School of Medicine, and co-authors from a task force created by the Critical Care Societies Collaborative (CCSC) describe a rigorous process they used to document 17 major professional societies' efforts to address burnout among health care professionals working in critical care, such as ICU physicians, physician assistants and nurses.

The task force explored perspectives on the role of these societies to address burnout and developed a "roadmap" that the societies can use to guide their efforts to promote critical care clinicians' well-being.

The CCSC, which has taken a number of actions to raise awareness of and address clinician burnout, consists of four major U.S.-based critical care professional societies: American Association of Critical-Care Nurses (AACN), American College of Chest Physicians (CHEST), American Thoracic Society (ATS) and Society of Critical Care Medicine (SCCM).

"The ATS has focused on clinician well-being for several years now," said Karen Collishaw, CAE, executive director of the American Thoracic Society and a co-author of this study. "Activities have ranged from holding live and virtual sessions discussing the problem and encouraging people to share experiences and ideas, hosting a wellness center (with dogs!) in the exhibit hall at our international conference, and collaborating with our peer critical care societies on projects such as this one looking at the role professional societies can play in tackling this issue."

ATS President Juan Celedón, MD, DrPH, ATSF, added, "The COVID-19 pandemic has only exacerbated the need for more of these activities and the ATS is committed to helping the pulmonary and critical care community stay well wherever we can."

Previous studies have explored individual and organizational solutions to address burnout, which is common among clinicians who deal with the many stressors of the critical care environment. This is the first peer-reviewed paper to discuss the role of professional societies in preventing or reducing burnout.

"High clinician burnout rates threaten the quality, safety and efficiency of clinical care, and research has shown that critical care clinicians are especially at risk," said Dr. Rinne. "Professional societies can play a key role in addressing burnout by promoting practices, policies, and norms that value clinician well-being."

He added, "Promoting clinician well-being is good for patients, and it is also the right thing to do. Clinicians suffering from burnout have higher rates of substance abuse, depression and suicidal ideation. The health and well-being of patients is directly tied to the health and well-being of clinicians and the health system at large."

The researchers conducted a multi-phased project from March to December 2019. First, they identified professional societies in critical care-related fields and documented their existing well-being initiatives. Next, they conducted interviews with representatives of selected societies in order to explore their perspectives on the role of professional societies in addressing burnout.

Finally, they reviewed results from the first two phases and engaged all task force members in a group discussion in order to develop a strategic roadmap that could guide critical care professional societies and inform professional societies in related fields. The task force attempted to relate all findings to a framework of factors influencing clinician burnout and well-being developed by CCSC and the National Academy of Medicine. The roadmap created based on this research includes the following recommendations:

1.Professional societies should acknowledge the problem of burnout among their members. In order to do this, the societies should first conduct internal research to assess the extent of burnout and any unique factors affecting members.
2.Leadership of each society must determine how well-being initiatives fit into their organizational structure and strategic priorities. Organizational leadership may want to embed well-being efforts into other strategic initiatives, or may focus separately on well-being.
3.Partnerships with other organizations–national and local professional societies, health care organizations, academic institutions, advocacy groups–working in the same field may help promote member well-being and provide useful resources. The National Academy of Medicine and other organizations can help facilitate these partnerships.
4.Professional societies can play an important role in educating and supporting members, and advocating for change. Members' health care institutions do not consistently address burnout, and may not even be supportive of such efforts; professional societies can meet this need.
5.By encouraging research focused on improving clinician well-being, societies can help foster innovation and collaboration.
6.Recent scientific literature has identified effective organizational and individual solutions to reduce clinician burnout, and these remedies should be supported. While both types of solutions are valuable, professional societies should emphasize the importance of organizational approaches, as these methods tend to be more effective at reducing burnout.

"We have outlined a number of steps that societies can take to address burnout, based on a rigorous process that led us to these targeted recommendations," concluded Dr. Rinne. "The first and most important step is that leadership must acknowledge the burden of burnout and promoting clinician well-being through taking measures that can contribute to a culture shift that supports well-being and values the humanity of clinical care."