title: Improving outcomes: focus on workplace issues.
abstract: OBJECTIVE
  Staff satisfaction has not traditionally been included as an intensive care unit quality indicator. The process of providing intensive care may profoundly affect clinicians. Dysfunctional encounters with coworkers and ethical burdens may extract a considerable personal toll and affect work attitudes and performance.
  
  
  RESULTS
  Mounting evidence indicates that psychosocial tensions, burnout and ethical stress are common and serious problems in the intensive care unit. These experiences impact negatively on job satisfaction, turnover, workplace disruption and patient care. Addressing workplace issues will help improve quality of care.
  
  
  CONCLUSIONS
  Two common sources of staff dissatisfaction are examined. Improving staff satisfaction can improve unit performance, and serve to attract and retain quality clinicians.
authors.affiliation: Pulmonary and Critical Care Medicine, Rush University Medical Center Chicago, Illinois, USA. Ellen_H_Elpern@rush.edu
authors.forename: Ellen H
authors.initials: EH
authors.lastname: Elpern
authors.forename: Michael R
authors.initials: MR
authors.lastname: Silver
mesh_terms: D002055:Burnout, Professional / Q000523:psychology*; D006801:Humans; D007362:Intensive Care Units; D007588:Job Satisfaction; D010563:Personnel Turnover; D019555:Physician-Nurse Relations; D000078329:Workforce; D017132:Workplace