Cool Down, Don’t Burnout

Harbor-UCLA Medical Center (Torrance, California)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Reducing burnout through healthy communication

Hospital Unit:

Cardiothoracic Intensive Care Unit

CSI Participants:

  • John Carlo Amante, BSN, RN
  • Lina Mares Blanco, BSN, RN
  • Francis De Guzman, ADN, RN
  • Tiffany Singletary, ADN, RN

Video Presentation

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Project Goals/Objectives:

  1. Increase nursing staff retention through enhancing communication
  2. Improve unit morale and relationship between day and night shift
  3. Enhance communication between the registered nurses and interdisciplinary staff through general suggestions and encouragement

Project Outcomes:

  1. Improved AACN Healthy Work Environment Assessment Tool (HWEAT) scores, specifically improved communication 10%
  2. Reduced Maslach Burnout Inventory (MBI) scores 15%
  3. Increased cohesive teamwork with our clinical nurse specialists, educators and managers

Project Overview:

Due to the nature of a cardiothoracic and trauma ICU unit, the self-reported feelings of burnout and high rates of turnover had been consistent problems during the pre-pandemic era. Our CSI team launched the AACN HWEAT tool to assess unit morale. The results indicated that all unit staff felt undervalued, 33% reported a sense of a lack of communication from management and 42% felt unheard by management. Our team also requested that unit staff complete the Maslach Burnout Tool to assess the level of burnout. The average burnout self-assessment score was 55, which indicates a severe risk for burnout.

Our CSI team decided to utilize a communication board for our intervention. The board consisted of three columns that assessed perceptions of the current shift: what went well during the shift, what could be improved during the shift and general suggestions for the unit. Rules for the board included upholding professionalism by prohibiting name blaming and maintaining anonymity, and for every improvement post, there must be positive feedback for the shift. Initially, the staff had some resistance to using the board, but by incorporating the board into a daily workflow, it was eventually accepted by staff on the unit.

Despite the COVID-19 pandemic, feedback for the project has been positive. Although we had four staff members leave the unit for opportunities in travel nursing, our incoming staff members and travel nurses reported feelings of camaraderie and unity in the unit. Nurses reported a 17% increase in feeling valued and 40% increase in feeling heard, plus an experience of improved communication on the unit. Average burnout self-assessment scores decreased to 50 an improvement of nearly 10%. Even with the challenges of COVID-19 and staffing issues, our unit remains resilient and seeks to continuously improve ourselves and our practice for safer patient outcomes.

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The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.