Ankita Agarwal, MD,
Emory University School of Medicine
Atlanta, Georgia
Disclosure information not submitted.
Taylor Barnes, B.S.
Medical Student
Oregon Health Sciences University, United States
Disclosure information not submitted.
Tina Chen, MD
Physician
Albert Einstein College of Medicine
Bronx, United States
Disclosure information not submitted.
Joshua Denson, MD
Physician
Tulane Medical Center, United States
Disclosure information not submitted.
Lauren Ferrante, MD, MHS
Physician
Yale University School of Medicine
Guilford, Connecticut, United States
Disclosure information not submitted.
Hayley Gershengorn, MD, ATSF,FCCM
Professor
University of Miami Miller School of Medicine
Miami, Florida
Disclosure information not submitted.
Navneet Kaur, MD
Fellow
Florida Atlantic University Charles E Schmidt College of Medicine
Boca Raton, Florida, United States
Disclosure information not submitted.
Courtney Lamberton, MD
Physician
University of Pennsylvania, United States
Disclosure information not submitted.
Patrick Lyons, MD
Physician
Barnes Jewish Hospital, United States
Disclosure information not submitted.
Nandita Nadig, MD, MSCR
Physician
Medical University of South Carolina
Charleston, South Carolina, United States
Disclosure information not submitted.
Anthony Pietropaoli, MD
Physician
Univ. of Rochester Medical Center, United States
Disclosure information not submitted.
Brian Poole, MD
Fellow
University of Utah Medical Center, United States
Disclosure information not submitted.
Elizabeth Viglianti, MD
Physician
University of Michigan, United States
Disclosure information not submitted.
Neal Dickert, MD, PhD
Physician
Emory University, United States
Disclosure information not submitted.
Craig Coopersmith, MD, FACS,MCCM
Director, Emory Critical Care Center
Emory University Hospital
Atlanta, Georgia
Disclosure information not submitted.
Mark Mikkelsen, MD, MSCE,FCCM
Physician
Hospital of the University of Pennsylvania, United States
Disclosure information not submitted.
Jonathan Sevransky, MD, MHS,FCCM
Professor
Emory University Hospital
Atlanta, Georgia
Disclosure information not submitted.
Title: SWEAT ICU – A Study of Workload and the Association of Outcomes in the ICU
Introduction: We investigated whether clinician workload is independently associated with burnout in ICU physicians and hypothesized an increase in burnout syndrome (BOS) in those caring for ≥14 patients.
Methods: A cross-sectional study across 14 SCCM Discovery sites from August 2020 to July 2021 assessing the association of ICU workload (patient: intensivist ratio) with clinician burnout. A key secondary outcome was 28-day patient mortality. Burnout syndrome (BOS) was measured by the Well-Being Index (WBI), a validated tool for BOS (scores -2 to 9, ≥4 = BOS). Clinician and patient characteristics were compared using Chi-square test (Fisher’s exact test for counts ≤ 5) for proportions and Wilcoxon Rank Sum test for medians. We used a logistic regression model to calculate odds ratios (OR) and 95% confidence intervals (CI) comparing clinician workload to burnout and patient outcomes. Workload was modeled as a dichotomous variable (high workload ≥ 14 patients, low workload < 14 patients), with a sensitivity analysis with workload as a linear variable.
Results: 107 physicians were enrolled with median patient: intensivist ratio of 12 (IQR 10-14), and median WBI score of 2 (IQR 1-4). Baseline characteristics (demographics, practice years, clinical weeks, ICU strain) were similar between physicians with high workload (n=37) or low workload (n=70). 1043 patients were included. Patients for clinicians with high workload had a higher median SOFA score compared to low workload (6 vs 5, p= 0.05), but no difference in prevalence of life-sustaining measures. BOS prevalence was 24% for physicians with high workload, and 29% with low workload (overall prevalence 27%). Our preliminary analysis showed no difference in BOS in those with high versus low workload, (unadjusted OR 0.80, 95% CI 0.32–2.00). When workload was treated as a linear variable, there was no difference between groups (p= 0.82). At day 28, 52% of patients were discharged, 20% still hospitalized, and 28% had died. There was no difference in patient outcomes between high versus low workload groups (28-day odds of death, unadjusted OR 0.85, 95% CI 0.63-1.15).
Conclusion: In our cohort, there was a lower than previously reported level of BOS and no relationship between workload and burnout. Factors other than workload may play important roles as drivers of burnout.