1.Burnout in the emergency department: Randomized controlled trial of an attention-based training program.
Pádraic J DUNNE ; Julie LYNCH ; Lucia PRIHODOVA ; Caoimhe O'LEARY ; Atiyeh GHOREYSHI ; Sharee A BASDEO ; Donal J COX ; Rachel BREEN ; Ali SHEIKHI ; Áine CARROLL ; Cathal WALSH ; Geraldine MCMAHON ; Barry WHITE
Journal of Integrative Medicine 2019;17(3):173-180
BACKGROUND:
Burnout (encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.
OBJECTIVE:
The aim of this study was to apply an attention-based training (ABT) program to reduce burnout among emergency multidisciplinary team (MDT) members from a large urban hospital.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS:
Emergency MDT members were randomized to either a no-treatment control or an intervention group. Intervention group participants engaged in a four session (4 h/session) ABT program over 7 weeks with a practice target of 20 min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device.
MAIN OUTCOME MEASURES:
The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters.
RESULTS:
The ABT program resulted in a significant reduction (P < 0.05; T1 [one week before intervention] vs T3 [follow-up at two months after intervention]) in burnout, specifically, emotional exhaustion, with an effect size (probability of superiority) of 59%. Similar reductions were observed for stress (P < 0.05) and anxiety (P < 0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression.
CONCLUSION:
This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group.
TRIAL REGISTRATION
ClinicalTrials.gov identifier NCT02887300.