Critical Care Societies Collaborative National Summit on Prevention & Management of Burnout

More than 50 national experts gathered in Naperville, Illinois, USA, in December 2017 for the Critical Care Societies Collaborative’s (CCSC) National Summit on Prevention and Management of Burnout. The CCSC consists of the Society of Critical Care Medicine (SCCM), American Association of Critical-Care Nurses (AACN), American Thoracic Society (ATS), and American College of Chest Physicians.

The daylong summit brought together leaders in the field of burnout syndrome (BOS) from a variety of backgrounds, including experts in integrative medicine, sociology, psychology, medicine, nursing, academics, professional healthcare organizations, and health professions students.

The day started with introductions and a musical entertainment from Andrew Schulman, a classical guitarist and medical musician, who played an instrumental version of George Harrison’s “Here Comes the Sun” on his guitar to give everyone gathered in the room time to reflect on this important topic and set the tone for the day. Mr. Schulman shared his personal experience of how music helped him heal during a 2009 stay in a surgical intensive care unit (ICU) for a life-threatening illness. He had been in a coma for six days when his wife played his favorite music on his iPad and sparked a response that he believed led to his recovery.

From there, experts in the field offered brief presentations that focused on successful programs at various institutions treating burnout, the state of the science, and reflections on the national conversation around resilience, healthy work environments, and wellness. Participants then spent majority of the day in breakout groups to address prevention, identification, and strategies for raising awareness and finding solutions to addressing burnout in critical care clinicians.

CCSC’s Call to Action
The summit was held as a next step after the CCSC published an official statement on BOS in critical care healthcare professionals. Published simultaneously in each organization’s journals, the call to action highlighted the definition of burnout syndrome as “an imbalance of personal characteristics of the employee and work-related issues or other organizational factors.” The call to action highlighted that BOS is associated with many adverse consequences, including increased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS can also affect the mental health and physical well-being of critical care physicians, nurses, and other healthcare professionals.¹

The statement offered a call to action for stakeholders to reduce the prevalence of burnout. The summit is one of many activities planned for achieving this goal. The CCSC intends to publish the proceedings from the summit including a research agenda. Additionally, representatives from each organization presented on aspects of the summit during the 47th Critical Care Congress. Many of the presenters and participants noted that the current efforts by the National Academy of Medicine to address clinician resilience, and the work of the CCSC, along with other groups, mark a shift in the culture and the way the medical community deals with burnout.

During the keynote presentation at the summit, Meredith L. Mealer, RN, PhD, a researcher who has explored strategies for promoting resilience noted, “I think we’ve finally reached a period of awakening on this topic . . . in part because of the Critical Care Societies Collaborative.” She went on to give an overview of the history of burnout and to share data from several surveys and work groups, including examples from a written exposure therapy exercise conducted with a group of nurses dealing with burnout. Nurses shared stories that revealed themes about how death, resuscitation, or failed resuscitation efforts or peer relationships contribute to burnout triggers. She highlighted organizational strategies to reduce burnout, including addressing the work environment through shorter rotations and reduced shifts with direct patient care, improving communication with hospital leadership and others, and changing the educational curriculum to incorporate mindfulness and coping skills, conflict management, and career counseling. She also spoke to the value of individual strategies such as stress management techniques and coping skills that build both psychological and moral resilience.

During the keynote presentation at the summit, Meredith L. Mealer, RN, PhD, a researcher who has explored strategies for promoting resilience noted, “I think we’ve finally reached a period of awakening on this topic . . . in part because of the Critical Care Societies Collaborative.” She went on to give an overview of the history of burnout and to share data from several surveys and work groups, including examples from a written exposure therapy exercise conducted with a group of nurses dealing with burnout. Nurses shared stories that revealed themes about how death, resuscitation, or failed resuscitation efforts or peer relationships contribute to burnout triggers. She highlighted organizational strategies to reduce burnout, including addressing the work environment through shorter rotations and reduced shifts with direct patient care, improving communication with hospital leadership and others, and changing the educational curriculum to incorporate mindfulness and coping skills, conflict management, and career counseling. She also spoke to the value of individual strategies such as stress management techniques and coping skills that build both psychological and moral resilience.

Vicki S. Good, DNP, RN, past president of AACN, and faculty for the summit, echoed that sentiment, noting, “Awareness is becoming much more front and center. In the past, people were having these feelings and frustrations, but didn’t know what to call it. Now, instead of it being a silent epidemic, it’s now coming more into the forefront.”

Offering Tools and Resources
As the stigma of psychological burnout lessens, it presents a unique opportunity to improve the health of critical care providers. One of the breakout groups focused on how ICU clinicians can identify burnout. Participants commented, “Most people who start in a new job don’t have symptoms of burnout. It evolves slowly over time. It’s sort of like when you need glasses. You don’t realize how your eyesight has gotten worse until you put on the glasses and realize you couldn’t see anymore.” Signs of burnout include emotional exhaustion, depersonalization, decreased feelings of personal accomplishment—one just doesn’t feel good about his or her job anymore.”

Other breakout groups addressed factors influencing burnout, such as risk factors specific to the ICU and organizational intervention, offering opportunities to share success stories from various institutions and advancing the research agenda, including identifying knowledge gaps and discussing how to continue forward in researching this topic.

“I thought the summit went really well. The people who devoted their time and effort . . . was pretty inspirational,” said Marc Moss, MD, 2017 president of ATS and faculty member for the summit. “The onus is now on the CCSC to figure out to properly utilize this information.”

Ruth M. Kleinpell, RN-CS, PhD, FCCM, the 2017 president of SCCM and faculty member for the summit, said she was hopeful that the summit served its purpose of raising awareness. “For years, it was a template. If you worked in the ICU you sort of “toughen up” and take what comes. I think there’s greater awareness now that we need to build resilience and recognize that individuals have to take care of themselves in order to be able to take care of patients and families in the ICU.”

Learn more about the CCSC efforts related to burnout at www.ccsconline.org. The website includes links to the presentations and interviews from the summit.

Join the conversation using the #StopICUBurnout hashtag on Twitter. 


CCSC Statement References

1. Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. An official Critical Care Societies Collaborative Statement: burnout syndrome in critical care healthcare professionals: a call for action. Crit Care Med. 2016 Jul;44(7):1414-1421.

2. Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. An official Critical Care Societies Collaborative Statement: burnout syndrome in critical care healthcare professionals: a call for action. Chest. 2016 Jul; 150(a):17-26

3. Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. An official Critical Care Societies Collaborative Statement: burnout syndrome in critical care healthcare professionals: a call for action. Am J Crit Care. 2016 Jul;25(4):368-76

4. Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. An official Critical Care Societies Collaborative Statement: burnout syndrome in critical care healthcare professionals: a call for action. Am J Respir Crit Care Med. 2016 Jul 1; 194(1):106-13.