Burnout decreases and job fulfillment improves when physicians work shorter rotations in the hospital, according to a new study.
The results, published Tuesday in the American Journal of Respiratory and Critical Care Medicine, found burnout was substantially lower among critical-care physicians at Penn Medicine who opted to shorten their clinical rotations from 14 consecutive days to seven days. The study shows 24% of physicians screened positive for burnout in an intensive-care unit that switched to seven-day rotations, while 61% of physicians in an ICU with both seven-day and 14-day rotations screened positive for burnout.
"Burnout is high in our community of intensivists, and there are relatively simple things we can do to mitigate that burnout including shorter rotations," said Dr. Meeta Prasad Kerlin, a co-author of the study and associate fellowship program director in the division of pulmonary, allergy and critical care at Penn Medicine.
In addition to lower burnout rates, feelings of job fulfillment were higher among physicians in the unit that switched to seven-day rotations versus the unit with a mixture of physicians with both seven-day and 14-day rotations.
Penn Medicine began to offer the seven-day rotations to ICU physicians in October 2018. Those participating switched one of their weeks with each other so that staffing wasn't affected, Kerlin said.
Interest in the offering was high with most critical-care doctors trying the new rotation at least once, said Dr. Mark Mikkelsen, lead author of the study and chief of medical critical care at Penn Medicine.
The idea to pilot a seven-day rotation came from the Critical Care Societies Collaborative, an organization that represents the major professional and scientific societies for the critically ill and injured. The collaborative is also interested in addressing the issue of burnout in the critical-care workforce.
Fourteen-day rotations are relatively common in critical-care medicine, but Kerlin said there has been growing interest in how shorter rotations can decrease burnout though it hasn't been tested until this study.
Since the pilot ended earlier this month, Penn Medicine has decided to keep the seven-day rotation offering since it was so popular.
Mikkelsen said while the change has benefited Penn Medicine's ICU doctors, it's important for clinical leaders to first understand where sources of burnout are coming from before implementing solutions. Penn Medicine surveyed its physicians and noticed the high levels of burnout before testing the seven-day rotation change.
"Every institution is going to have an individualized solution to the problem," Kerlin added.