• Anuj B Mehta, Steven Lockhart, Kathryne Reed, Christine Griesmer, Russell E Glasgow, Marc Moss, Ivor S Douglas, and Megan A Morris.
• Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Denver Health & Hospital Association, Denver, CO; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO. Electronic address: anuj.mehta@cuanschutz.edu.
• Chest. 2022 May 1; 161 (5): 126312741263-1274.

BackgroundCritical care practitioners have some of the highest levels of burnout in health care.Research QuestionWhat are key drivers of burnout across the multidisciplinary ICU team?Study Design And MethodsWe conducted a multicenter mixed-methods cohort study in ICUs at three diverse hospitals. We recruited physicians, nurses, respiratory therapists, and other staff members who worked primarily in an ICU. Participants completed the Maslach Burnout Inventory for Human Services Survey for Medical Personnel (MBI) and a qualitative focus group or interview using a phenomenologic approach. MBI subscales for emotional exhaustion, depersonalization, and lack of personal accomplishment were calculated. Emergent shared themes contributing to burnout were identified from qualitative interviews.ResultsFifty-eight providers (26 physicians, 22 nurses, six respiratory therapists, three pharmacists, and one case manager) participated. Ten participants (17.9%) described their burnout as moderate to high. However, participants scored moderate or high levels across the three MBI subscales (emotional exhaustion, 71.4%; depersonalization, 53.6%; and lack of personal achievement, 53.6%). Drivers of burnout aligned with three core themes: patient factors, team dynamics, and hospital culture. Individual drivers included medically futile cases, difficult families, contagiousness of burnout, lack of respect between team members, the increasing burden of administrative or regulatory requirements at the cost of time with patients, lack of recognition from hospital leadership, and technology. All were highly interconnected across the three larger domains. Despite differences in MBI scores, most provider types described very similar drivers of burnout.InterpretationHigh levels of burnout were identified through the MBI, but participants did not self-report high levels of burnout, suggesting a lack of awareness. Drivers of burnout were highly interconnected, but factors related to team dynamics and hospital culture were most prominent and shared across provider types. The shared drivers of burnout across multiple provider types highlights the need for interventions focused on team- and system-level drivers.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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