- Email: [email protected]
Beyond clinician burnout predisposing factors, what is the appropriate intervention?
Accepted Manuscript Beyond clinician burnout predisposing factors, what is the appropriate intervention? Amr S. Omar, MD, PhD, MBA, Adel Taha, MD, PhD PII:
S2210-8440(17)30073-4
DOI:
10.1016/j.tacc.2017.03.005
Reference:
TACC 344
To appear in:
Trends in Anaesthesia and Critical Care
Received Date: 29 January 2017 Revised Date:
26 March 2017
Accepted Date: 30 March 2017
Please cite this article as: Omar AS, Taha A, Beyond clinician burnout predisposing factors, what is the appropriate intervention?, Trends in Anaesthesia and Critical Care (2017), doi: 10.1016/ j.tacc.2017.03.005. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Title Page
RI PT
Beyond clinician burnout predisposing factors, what is the appropriate intervention?
Amr S Omar, MD, PhD, MBA 1,2,3*Email: [email protected]
M AN U
SC
Adel Taha, MD, PhD 4
1 Department of Cardiothoracic Surgery/ ICU Section,
Heart Hospital, Hamad Medical Corporation, Doha, (PO: 3050), Qatar 2 Department of Clinical Medicine, Weill Cornell Medical College Qatar 3 Department of Critical Care Medicine, Beni Suef University, Egypt
EP
TE D
4 Department of critical care medicine, Kink Khaled specialized hospital, Damam, Saudi Arabia
* Corresponding author. Department of Cardiothoracic Surgery/ICU Section, Heart Hospital, Hamad Medical Corporation, Doha,
AC C
(PO: 3050), Qatar. Tel: (+974) 44395897 Fax: (+974) 44395362 Email: [email protected] Running head: burnout, intensive care Abstract word count: (Structured=330) Text word count including references: 498
Tables: 0
Figures: 0
ACCEPTED MANUSCRIPT
Beyond clinician burnout predisposing factors, what is the appropriate intervention?
RI PT
Dear Editor, The rise of burnout signals is alarming worldwide. Bienvenu [1], summarized the predisposing risk factors for clinician burnout to include younger clinicians without
SC
families, overloaded work schedule, practitioners dealing with withdrawing life support decisions, quality of working relationships, practitioners who care for dying patients, and
M AN U
visiting hours policy.
Fassier and Azoulay emphasized the critical value of individual control at workplace where dispute and conflicts enhance the burnout development [2] moreover, unclear roles
TE D
and assignments is another burnout potentiation. Slight in the decision-making could be associated with reduced performance and lower workload coordination and hence the reducing the control, lowering the chances of achieving individuals commitment, with
EP
lower energy and health. [3] Unfair intrinsic or extrinsic rewarding system indeed could
AC C
increase the chances for burnout experience. [3].
Understanding the traumatizing factors is needed to prevent burnout. Social
interaction, conflicts, reciprocal support, vicinity, and teamwork are the core value of organizational community. Pross (2006) empahsized that community related social and political pressure put the employers under stress. Population characteristics, and financial backup, public support and financial backup undergo continuous changes which could be
ACCEPTED MANUSCRIPT
reflected on the workers stress. [4] Hobfoll (2001) added that trends to resources conservation could decipher the resource loss in stressful situations. Resources conservation and appraisal-based procedures could be influential for the stress process.
RI PT
[5]
SC
Recently nationality emerges in evolvement of burnout. Omar et al (2015) reported higher burnout in Syrian practitioners working in a multinational community, where civil
M AN U
war in their native country added to the manifest stressors. [6] Similarly Al-Turki [6] et al., (2010) found that non-Saudi nurses were more susceptible to emotional exhaustion than Saudi nurses. [7] Satisfaction and well-being of the physician appear to be linked to the leadership quality. This in turn gives evidence about the importance of leadership
TE D
selection in attempt to reduce burnout. [8] There is a growing awareness that physician burnout is influenced by institutional factors including the practice environment efficacy, the practitioners provided autonomy, and workload. [8 -11]
EP
A recent systemic review and meta-analysis summarized the interventions required for burnout reduction into organizational and individual focused approaches. [12] The
AC C
diversity of predisposing factors of burnout mandate working plan aim at early recognition and organization based management, hence reducing chances for its evolvement.
Conclusions
ACCEPTED MANUSCRIPT
Burnout is getting more attention, appropriate intervention should aim at better orientation, early identification, and management of predisposing factors could prevent
RI PT
its hazardous on practitioners.
Compliance with ethical standards
SC
Conflicts of interest
Dr. Omar is a consultant in Hamad Medical Corporation (HMC), Qatar, declares no
the content of this article. References
M AN U
potential financial or personal conflict of interest with a third party that could influence
1) Bienvenu OJ (2016). Is this critical care clinician burned out?. Intensive Care
TE D
Medicine. Aug 16:1-3.
2) Fassier T, Azoulay E. (2010) Conflicts and communication gaps in the intensive care unit. Current opinion in critical care. Dec 1;16(6):654-65..
EP
3) Maslach C, Leiter MP (2008). Early predictors of job burnout and engagement. Journal of applied psychology. May;93(3):498.
AC C
4) Pross C (2006). Burnout, vicarious traumatization and its prevention. Torture. 2006;16(1):1-9.
5) Hobfoll SE (2001). The influence of culture, community, and the nested‐self in the stress process: advancing conservation of resources theory. Applied psychology. Jul 1;50(3):337-421.
ACCEPTED MANUSCRIPT
6) Omar AS, Elmaraghi S, Mahmoud MS, et al., (2015). Impact of leadership on ICU clinicians’ burnout. Intensive Care Med. Nov 1;18(3):139. 7) Al-Turki HA, Al-Turki RA, Al-Dardas HA, et al., (2010). Burnout syndrome
RI PT
among multinational nurses working in Saudi Arabia. Annals of African Medicine. Oct 1;9(4).
8) Shanafelt TD, Gorringe G, Menaker R, et al.,(2015). Impact of organizational
M AN U
30 (Vol. 90, No. 4, pp. 432-440). Elsevier.
SC
leadership on physician burnout and satisfaction. In Mayo Clinic Proceedings Apr
9) Wallace JE, Lemaire JB, Ghali WA. (2009). Physician wellness: a missing quality indicator. Lancet.;374(9702):1714-172
10) Van Bogaert P, Peremans L, Van Heusden D, et al., (2017) Predictors of burnout,
TE D
work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC nursing. Jan 18;16(1):5.. 11) Egener B, McDonald W, Rosof B, et al., (2012). Perspective: organizational relevant
EP
professionalism:
competencies
and
behaviors.
Acad
Med.
AC C
2012;87(5):668-674.
12) West CP, Dyrbye LN, Erwin PJ, et al., (2016) Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet. Nov 11;388(10057):2272-81.
ACCEPTED MANUSCRIPT
Highlights
1) The rise of burnout signals is increasing worldwide. 2) Predisposing factors of burnout are diverse and need a working plan aimed at early
evolvement.
AC C
EP
TE D
M AN U
SC
3) The latter could prevent its hazards for practitioners.
RI PT
recognition and organization based management, hence reducing chances for its
S2210-8440(17)30073-4
DOI:
10.1016/j.tacc.2017.03.005
Reference:
TACC 344
To appear in:
Trends in Anaesthesia and Critical Care
Received Date: 29 January 2017 Revised Date:
26 March 2017
Accepted Date: 30 March 2017
Please cite this article as: Omar AS, Taha A, Beyond clinician burnout predisposing factors, what is the appropriate intervention?, Trends in Anaesthesia and Critical Care (2017), doi: 10.1016/ j.tacc.2017.03.005. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Title Page
RI PT
Beyond clinician burnout predisposing factors, what is the appropriate intervention?
Amr S Omar, MD, PhD, MBA 1,2,3*Email: [email protected]
M AN U
SC
Adel Taha, MD, PhD 4
1 Department of Cardiothoracic Surgery/ ICU Section,
Heart Hospital, Hamad Medical Corporation, Doha, (PO: 3050), Qatar 2 Department of Clinical Medicine, Weill Cornell Medical College Qatar 3 Department of Critical Care Medicine, Beni Suef University, Egypt
EP
TE D
4 Department of critical care medicine, Kink Khaled specialized hospital, Damam, Saudi Arabia
* Corresponding author. Department of Cardiothoracic Surgery/ICU Section, Heart Hospital, Hamad Medical Corporation, Doha,
AC C
(PO: 3050), Qatar. Tel: (+974) 44395897 Fax: (+974) 44395362 Email: [email protected] Running head: burnout, intensive care Abstract word count: (Structured=330) Text word count including references: 498
Tables: 0
Figures: 0
ACCEPTED MANUSCRIPT
Beyond clinician burnout predisposing factors, what is the appropriate intervention?
RI PT
Dear Editor, The rise of burnout signals is alarming worldwide. Bienvenu [1], summarized the predisposing risk factors for clinician burnout to include younger clinicians without
SC
families, overloaded work schedule, practitioners dealing with withdrawing life support decisions, quality of working relationships, practitioners who care for dying patients, and
M AN U
visiting hours policy.
Fassier and Azoulay emphasized the critical value of individual control at workplace where dispute and conflicts enhance the burnout development [2] moreover, unclear roles
TE D
and assignments is another burnout potentiation. Slight in the decision-making could be associated with reduced performance and lower workload coordination and hence the reducing the control, lowering the chances of achieving individuals commitment, with
EP
lower energy and health. [3] Unfair intrinsic or extrinsic rewarding system indeed could
AC C
increase the chances for burnout experience. [3].
Understanding the traumatizing factors is needed to prevent burnout. Social
interaction, conflicts, reciprocal support, vicinity, and teamwork are the core value of organizational community. Pross (2006) empahsized that community related social and political pressure put the employers under stress. Population characteristics, and financial backup, public support and financial backup undergo continuous changes which could be
ACCEPTED MANUSCRIPT
reflected on the workers stress. [4] Hobfoll (2001) added that trends to resources conservation could decipher the resource loss in stressful situations. Resources conservation and appraisal-based procedures could be influential for the stress process.
RI PT
[5]
SC
Recently nationality emerges in evolvement of burnout. Omar et al (2015) reported higher burnout in Syrian practitioners working in a multinational community, where civil
M AN U
war in their native country added to the manifest stressors. [6] Similarly Al-Turki [6] et al., (2010) found that non-Saudi nurses were more susceptible to emotional exhaustion than Saudi nurses. [7] Satisfaction and well-being of the physician appear to be linked to the leadership quality. This in turn gives evidence about the importance of leadership
TE D
selection in attempt to reduce burnout. [8] There is a growing awareness that physician burnout is influenced by institutional factors including the practice environment efficacy, the practitioners provided autonomy, and workload. [8 -11]
EP
A recent systemic review and meta-analysis summarized the interventions required for burnout reduction into organizational and individual focused approaches. [12] The
AC C
diversity of predisposing factors of burnout mandate working plan aim at early recognition and organization based management, hence reducing chances for its evolvement.
Conclusions
ACCEPTED MANUSCRIPT
Burnout is getting more attention, appropriate intervention should aim at better orientation, early identification, and management of predisposing factors could prevent
RI PT
its hazardous on practitioners.
Compliance with ethical standards
SC
Conflicts of interest
Dr. Omar is a consultant in Hamad Medical Corporation (HMC), Qatar, declares no
the content of this article. References
M AN U
potential financial or personal conflict of interest with a third party that could influence
1) Bienvenu OJ (2016). Is this critical care clinician burned out?. Intensive Care
TE D
Medicine. Aug 16:1-3.
2) Fassier T, Azoulay E. (2010) Conflicts and communication gaps in the intensive care unit. Current opinion in critical care. Dec 1;16(6):654-65..
EP
3) Maslach C, Leiter MP (2008). Early predictors of job burnout and engagement. Journal of applied psychology. May;93(3):498.
AC C
4) Pross C (2006). Burnout, vicarious traumatization and its prevention. Torture. 2006;16(1):1-9.
5) Hobfoll SE (2001). The influence of culture, community, and the nested‐self in the stress process: advancing conservation of resources theory. Applied psychology. Jul 1;50(3):337-421.
ACCEPTED MANUSCRIPT
6) Omar AS, Elmaraghi S, Mahmoud MS, et al., (2015). Impact of leadership on ICU clinicians’ burnout. Intensive Care Med. Nov 1;18(3):139. 7) Al-Turki HA, Al-Turki RA, Al-Dardas HA, et al., (2010). Burnout syndrome
RI PT
among multinational nurses working in Saudi Arabia. Annals of African Medicine. Oct 1;9(4).
8) Shanafelt TD, Gorringe G, Menaker R, et al.,(2015). Impact of organizational
M AN U
30 (Vol. 90, No. 4, pp. 432-440). Elsevier.
SC
leadership on physician burnout and satisfaction. In Mayo Clinic Proceedings Apr
9) Wallace JE, Lemaire JB, Ghali WA. (2009). Physician wellness: a missing quality indicator. Lancet.;374(9702):1714-172
10) Van Bogaert P, Peremans L, Van Heusden D, et al., (2017) Predictors of burnout,
TE D
work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC nursing. Jan 18;16(1):5.. 11) Egener B, McDonald W, Rosof B, et al., (2012). Perspective: organizational relevant
EP
professionalism:
competencies
and
behaviors.
Acad
Med.
AC C
2012;87(5):668-674.
12) West CP, Dyrbye LN, Erwin PJ, et al., (2016) Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet. Nov 11;388(10057):2272-81.
ACCEPTED MANUSCRIPT
Highlights
1) The rise of burnout signals is increasing worldwide. 2) Predisposing factors of burnout are diverse and need a working plan aimed at early
evolvement.
AC C
EP
TE D
M AN U
SC
3) The latter could prevent its hazards for practitioners.
RI PT
recognition and organization based management, hence reducing chances for its