(1583) Critical Care Practice Models: Is There an Ingredient for Success?

Introduction: Readiness to address global pandemic is vital to critical care capacity building. This study seeks to understand the various practice models pre- and post-COVID surge, changes to clinical practice, association with clinician burnout, and factors contributing to staff readiness during the surge.

Methods: A nationwide cross-sectional survey was distributed to all critical care clinicians. Mixed Design ANOVA with customized hypothesis and post hoc tests for follow-up was used to assess changes in burnout across practice models and years of experience.

Results: 533 multidisciplinary clinicians completed the survey. A statistically significant increase in burnout was reported among all clinicians during the covid surge (p <.0001). Most respondents worked in a dedicated critical care model prior to the pandemic (41.5%) vs. (26.2%) and transitioned to a cross-trained practice model post-pandemic surge. Prior to the pandemic cross-trained practice model accounted for (23.31%) vs. (17%) that transitioned to a dedicated model post-pandemic. Clinicians who remained in a dedicated practice model had less burnout than those who worked in a cross-trained model (p=.026); however, no evidence that those who changed practice mode post-pandemic had a difference in burnout (p=0.48). Clinicians with experience of less than 15 years had more burnout than those with greater than 15 years of experience (p <.001). “Feeling stressed” was the greatest factor contributing to burnout before and after the pandemic. Nonphysicians and non-advanced practice providers experienced more increased burnout than physicians (p < 0.001). Generally, most participants felt prepared for the next pandemic (p <.001).

Conclusions: This study serves as a starting point to better understand the effects the stresses of a pandemic have on healthcare providers. We were able to demonstrate that the changes to clinical practice that are necessary to deal with a pandemic, maybe detrimental to clinicians. Also demonstrated in this work was the protective effect experience had on the feeling of burnout. The trials of the pandemic appear to have fostered resiliency among providers, as demonstrated by the feeling of preparedness for a future pandemic. Further research is necessary when preparing for the next global health crisis.