Promoting Staff Resilience in the Pediatric Intensive Care Unit.
BACKGROUND
Health care professionals experience workplace stress, which may lead to impaired physical and mental health, job turnover, and burnout. Resilience allows people to handle stress positively. Little research is aimed at finding interventions to improve resilience in health care professionals.


OBJECTIVE
To describe the availability, use, and helpfulness of resilience-promoting resources and identify an intervention to implement across multiple pediatric intensive care units.


METHODS
A descriptive study collecting data on availability, utilization, and impact of resilience resources from leadership teams and individual staff members in pediatric intensive care units, along with resilience scores and teamwork climate scores.


RESULTS
Leadership teams from 20 pediatric intensive care units completed the leadership survey. Individual surveys were completed by 1066 staff members (51% response rate). The 2 most used and impactful resources were 1-on-1 discussions with colleagues and informal social interactions with colleagues out of the hospital. Other resources (taking a break from stressful patients, being relieved of duty after your patient's death, palliative care support for staff, structured social activities out of hospital, and Schwartz Center rounds) were highly impactful but underused. Utilization and impact of resources differed significantly between professions, between those with higher versus lower resilience, and between individuals in units with low versus high teamwork climate.


CONCLUSIONS
Institutions could facilitate access to peer discussions and social interactions to promote resilience. Highly impactful resources with low utilization could be targets for improved access. Differences in utilization and impact between groups suggest that varied interventions would be necessary to reach all individuals.
K. Jane Lee is an associate professor in the Department of Pediatrics and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin. Michael L. Forbes is director of clinical research and outcomes analysis in the Department of Pediatrics, Akron Children's Hospital, Akron, Ohio. Gloria J. Lukasiewicz is an analyst for the Children's Hospital Association, Washington, DC. Trisha Williams is a former clinical research coordinator in the Children's Mercy Hospital and Clinics, Kansas City, Missouri. Anna Sheets is clinical director of the cardiac intensive care unit, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio. Kay Fischer is former director of pediatric critical care services, Children's Hospital of Wisconsin, Milwaukee, Wisconsin. Matthew F. Niedner is an assistant professor in the Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan. kjlee@mcw.edu.
K Jane
KJ
Lee
K. Jane Lee is an associate professor in the Department of Pediatrics and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin. Michael L. Forbes is director of clinical research and outcomes analysis in the Department of Pediatrics, Akron Children's Hospital, Akron, Ohio. Gloria J. Lukasiewicz is an analyst for the Children's Hospital Association, Washington, DC. Trisha Williams is a former clinical research coordinator in the Children's Mercy Hospital and Clinics, Kansas City, Missouri. Anna Sheets is clinical director of the cardiac intensive care unit, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio. Kay Fischer is former director of pediatric critical care services, Children's Hospital of Wisconsin, Milwaukee, Wisconsin. Matthew F. Niedner is an assistant professor in the Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan.
Michael L
ML
Forbes
K. Jane Lee is an associate professor in the Department of Pediatrics and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin. Michael L. Forbes is director of clinical research and outcomes analysis in the Department of Pediatrics, Akron Children's Hospital, Akron, Ohio. Gloria J. Lukasiewicz is an analyst for the Children's Hospital Association, Washington, DC. Trisha Williams is a former clinical research coordinator in the Children's Mercy Hospital and Clinics, Kansas City, Missouri. Anna Sheets is clinical director of the cardiac intensive care unit, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio. Kay Fischer is former director of pediatric critical care services, Children's Hospital of Wisconsin, Milwaukee, Wisconsin. Matthew F. Niedner is an assistant professor in the Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan.
Gloria J
GJ
Lukasiewicz
K. Jane Lee is an associate professor in the Department of Pediatrics and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin. Michael L. Forbes is director of clinical research and outcomes analysis in the Department of Pediatrics, Akron Children's Hospital, Akron, Ohio. Gloria J. Lukasiewicz is an analyst for the Children's Hospital Association, Washington, DC. Trisha Williams is a former clinical research coordinator in the Children's Mercy Hospital and Clinics, Kansas City, Missouri. Anna Sheets is clinical director of the cardiac intensive care unit, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio. Kay Fischer is former director of pediatric critical care services, Children's Hospital of Wisconsin, Milwaukee, Wisconsin. Matthew F. Niedner is an assistant professor in the Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan.
Trisha
T
Williams
K. Jane Lee is an associate professor in the Department of Pediatrics and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin. Michael L. Forbes is director of clinical research and outcomes analysis in the Department of Pediatrics, Akron Children's Hospital, Akron, Ohio. Gloria J. Lukasiewicz is an analyst for the Children's Hospital Association, Washington, DC. Trisha Williams is a former clinical research coordinator in the Children's Mercy Hospital and Clinics, Kansas City, Missouri. Anna Sheets is clinical director of the cardiac intensive care unit, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio. Kay Fischer is former director of pediatric critical care services, Children's Hospital of Wisconsin, Milwaukee, Wisconsin. Matthew F. Niedner is an assistant professor in the Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan.
Anna
A
Sheets
K. Jane Lee is an associate professor in the Department of Pediatrics and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin. Michael L. Forbes is director of clinical research and outcomes analysis in the Department of Pediatrics, Akron Children's Hospital, Akron, Ohio. Gloria J. Lukasiewicz is an analyst for the Children's Hospital Association, Washington, DC. Trisha Williams is a former clinical research coordinator in the Children's Mercy Hospital and Clinics, Kansas City, Missouri. Anna Sheets is clinical director of the cardiac intensive care unit, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio. Kay Fischer is former director of pediatric critical care services, Children's Hospital of Wisconsin, Milwaukee, Wisconsin. Matthew F. Niedner is an assistant professor in the Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan.
Kay
K
Fischer
K. Jane Lee is an associate professor in the Department of Pediatrics and Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin. Michael L. Forbes is director of clinical research and outcomes analysis in the Department of Pediatrics, Akron Children's Hospital, Akron, Ohio. Gloria J. Lukasiewicz is an analyst for the Children's Hospital Association, Washington, DC. Trisha Williams is a former clinical research coordinator in the Children's Mercy Hospital and Clinics, Kansas City, Missouri. Anna Sheets is clinical director of the cardiac intensive care unit, Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio. Kay Fischer is former director of pediatric critical care services, Children's Hospital of Wisconsin, Milwaukee, Wisconsin. Matthew F. Niedner is an assistant professor in the Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, Ann Arbor, Michigan.
Matthew F
MF
Niedner
D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007857:Leadership; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D015397:Program Evaluation; D055500:Resilience, Psychological; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology / Q000706:statistics & numerical data