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SWEAT ICU—An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs
The optimal staffing model for physicians in the ICU is unknown. Patient-to-intensivist ratios may offer a simple measure of workload and be associated with patient mortality and physician burnout. To evaluate the association of physician workload, as measured by the patient-to-intensivist ratio, wi...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575792/ https://www.ncbi.nlm.nih.gov/pubmed/36259061 http://dx.doi.org/10.1097/CCE.0000000000000774 |
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author | Agarwal, Ankita Chen, Jen-Ting Coopersmith, Craig M. Denson, Joshua L. Dickert, Neal W. Ferrante, Lauren E. Gershengorn, Hayley B. Gosine, Adhiraj D. Hayward, Bradley J. Kaur, Navneet Khan, Akram Lamberton, Courtney Landsittel, Douglas Lyons, Patrick G. Mikkelsen, Mark E. Nadig, Nandita R. Pietropaoli, Anthony P. Poole, Brian R. Viglianti, Elizabeth M. Sevransky, Jonathan E. |
author_facet | Agarwal, Ankita Chen, Jen-Ting Coopersmith, Craig M. Denson, Joshua L. Dickert, Neal W. Ferrante, Lauren E. Gershengorn, Hayley B. Gosine, Adhiraj D. Hayward, Bradley J. Kaur, Navneet Khan, Akram Lamberton, Courtney Landsittel, Douglas Lyons, Patrick G. Mikkelsen, Mark E. Nadig, Nandita R. Pietropaoli, Anthony P. Poole, Brian R. Viglianti, Elizabeth M. Sevransky, Jonathan E. |
author_sort | Agarwal, Ankita |
collection | PubMed |
description | The optimal staffing model for physicians in the ICU is unknown. Patient-to-intensivist ratios may offer a simple measure of workload and be associated with patient mortality and physician burnout. To evaluate the association of physician workload, as measured by the patient-to-intensivist ratio, with physician burnout and patient mortality. DESIGN: Cross-sectional observational study. SETTING: Fourteen academic centers in the United States from August 2020 to July 2021. SUBJECTS: We enrolled ICU physicians and collected data on adult ICU patients under the physician’s care on the single physician-selected study day for each physician. MEASUREMENTS AND MAIN RESULTS: The primary exposure was workload (self-reported number of patients’ physician was responsible for) modeled as high (>14 patients) and low (≤14 patients). The primary outcome was burnout, measured by the Well-Being Index. The secondary outcome measure was 28-day patient mortality. We calculated odds ratio for burnout and patient outcomes using a multivariable logistic regression model and a binomial mixed effects model, respectively. We enrolled 122 physicians from 62 ICUs. The median patient-to-intensivist ratio was 12 (interquartile range, 10–14), and the overall prevalence of burnout was 26.4% (n = 32). Intensivist workload was not independently associated with burnout (adjusted odds ratio, 0.74; 95% CI, 0.24–2.23). Of 1,322 patients, 679 (52%) were discharged alive from the hospital, 257 (19%) remained hospitalized, and 347 (26%) were deceased by day 28; 28-day outcomes were unknown for 39 of patients (3%). Intensivist workload was not independently associated with 28-day patient mortality (adjusted odds ratio, 1.33; 95% CI, 0.92–1.91). CONCLUSIONS: In our cohort, approximately one in four physicians experienced burnout on the study day. There was no relationship be- tween workload as measured by patient-to-intensivist ratio and burnout. Factors other than the number of patients may be important drivers of burnout among ICU physicians. |
format | Online Article Text |
id | pubmed-9575792 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-95757922022-10-17 SWEAT ICU—An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs Agarwal, Ankita Chen, Jen-Ting Coopersmith, Craig M. Denson, Joshua L. Dickert, Neal W. Ferrante, Lauren E. Gershengorn, Hayley B. Gosine, Adhiraj D. Hayward, Bradley J. Kaur, Navneet Khan, Akram Lamberton, Courtney Landsittel, Douglas Lyons, Patrick G. Mikkelsen, Mark E. Nadig, Nandita R. Pietropaoli, Anthony P. Poole, Brian R. Viglianti, Elizabeth M. Sevransky, Jonathan E. Crit Care Explor Observational Study The optimal staffing model for physicians in the ICU is unknown. Patient-to-intensivist ratios may offer a simple measure of workload and be associated with patient mortality and physician burnout. To evaluate the association of physician workload, as measured by the patient-to-intensivist ratio, with physician burnout and patient mortality. DESIGN: Cross-sectional observational study. SETTING: Fourteen academic centers in the United States from August 2020 to July 2021. SUBJECTS: We enrolled ICU physicians and collected data on adult ICU patients under the physician’s care on the single physician-selected study day for each physician. MEASUREMENTS AND MAIN RESULTS: The primary exposure was workload (self-reported number of patients’ physician was responsible for) modeled as high (>14 patients) and low (≤14 patients). The primary outcome was burnout, measured by the Well-Being Index. The secondary outcome measure was 28-day patient mortality. We calculated odds ratio for burnout and patient outcomes using a multivariable logistic regression model and a binomial mixed effects model, respectively. We enrolled 122 physicians from 62 ICUs. The median patient-to-intensivist ratio was 12 (interquartile range, 10–14), and the overall prevalence of burnout was 26.4% (n = 32). Intensivist workload was not independently associated with burnout (adjusted odds ratio, 0.74; 95% CI, 0.24–2.23). Of 1,322 patients, 679 (52%) were discharged alive from the hospital, 257 (19%) remained hospitalized, and 347 (26%) were deceased by day 28; 28-day outcomes were unknown for 39 of patients (3%). Intensivist workload was not independently associated with 28-day patient mortality (adjusted odds ratio, 1.33; 95% CI, 0.92–1.91). CONCLUSIONS: In our cohort, approximately one in four physicians experienced burnout on the study day. There was no relationship be- tween workload as measured by patient-to-intensivist ratio and burnout. Factors other than the number of patients may be important drivers of burnout among ICU physicians. Lippincott Williams & Wilkins 2022-10-13 /pmc/articles/PMC9575792/ /pubmed/36259061 http://dx.doi.org/10.1097/CCE.0000000000000774 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Observational Study Agarwal, Ankita Chen, Jen-Ting Coopersmith, Craig M. Denson, Joshua L. Dickert, Neal W. Ferrante, Lauren E. Gershengorn, Hayley B. Gosine, Adhiraj D. Hayward, Bradley J. Kaur, Navneet Khan, Akram Lamberton, Courtney Landsittel, Douglas Lyons, Patrick G. Mikkelsen, Mark E. Nadig, Nandita R. Pietropaoli, Anthony P. Poole, Brian R. Viglianti, Elizabeth M. Sevransky, Jonathan E. SWEAT ICU—An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs |
title | SWEAT ICU—An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs |
title_full | SWEAT ICU—An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs |
title_fullStr | SWEAT ICU—An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs |
title_full_unstemmed | SWEAT ICU—An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs |
title_short | SWEAT ICU—An Observational Study of Physician Workload and the Association of Physician Outcomes in Academic ICUs |
title_sort | sweat icu—an observational study of physician workload and the association of physician outcomes in academic icus |
topic | Observational Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575792/ https://www.ncbi.nlm.nih.gov/pubmed/36259061 http://dx.doi.org/10.1097/CCE.0000000000000774 |
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