Randomized controlled trial of the "WISER" intervention to reduce healthcare worker burnout

Jochen Profit; Kathryn C Adair; Xin Cui; Briana Mitchell; Debra Brandon; Daniel S Tawfik; Joseph Rigdon; Jeffrey B Gould; Henry C Lee; Wendy L Timpson; Martin J McCaffrey; Alexis S Davis; Mohan Pammi; Melissa Matthews; Ann R Stark; Lu-Ann Papile; Eric Thomas; Michael Cotten; Amir Khan; J Bryan Sexton

doi:10.1038/s41372-021-01100-y

Randomized controlled trial of the "WISER" intervention to reduce healthcare worker burnout

J Perinatol. 2021 Sep;41(9):2225-2234. doi: 10.1038/s41372-021-01100-y. Epub 2021 Aug 9.

Authors

Jochen Profit^{1

2}, Kathryn C Adair^{3

4}, Xin Cui^{1

2}, Briana Mitchell¹, Debra Brandon^{5

6}, Daniel S Tawfik⁷, Joseph Rigdon⁸, Jeffrey B Gould^{1

2}, Henry C Lee^{1

2}, Wendy L Timpson⁹, Martin J McCaffrey¹⁰, Alexis S Davis¹, Mohan Pammi¹¹, Melissa Matthews¹², Ann R Stark¹³, Lu-Ann Papile¹⁴, Eric Thomas¹⁵, Michael Cotten¹⁶, Amir Khan¹⁴, J Bryan Sexton^{17

18}

Affiliations

¹ Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA.
² California Perinatal Quality Care Collaborative, Palo Alto, CA, USA.
³ Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, NC, USA.
⁴ Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC, USA.
⁵ Duke University School of Nursing, Durham, USA.
⁶ Department of Pediatrics, Duke University School of Medicine, Durham, USA.
⁷ Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA.
⁸ Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA.
⁹ Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
¹⁰ Division of Neonatal-Perinatal Medicine, University of North Carolina Chapel Hill School of Medicine and University of North Carolina Children's Hospital, Chapel Hill, NC, USA.
¹¹ Section of Neonatology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
¹² Department of Pediatrics-Neonatology, The University of Texas Health Science Center and Children's Memorial Hermann Hospital, Houston, TX, USA.
¹³ Department of Pediatrics, Division of Newborn Medicine, Harvard Medical School, Boston, MA, USA.
¹⁴ Division of Neonatology, Department of Pediatrics, The University of New Mexico School of Medicine, Albuquerque, NM, USA.
¹⁵ Department of Internal Medicine, The University of Texas Health Science Center and Memorial Hermann Medical Center, Houston, TX, USA.
¹⁶ Division of Pediatrics-Neonatology, Duke University School of Medicine and Duke University Hospital, Durham, NC, USA.
¹⁷ Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, NC, USA. Bryan.Sexton@Duke.edu.
¹⁸ Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC, USA. Bryan.Sexton@Duke.edu.

Abstract

Objective: Test web-based implementation for the science of enhancing resilience (WISER) intervention efficacy in reducing healthcare worker (HCW) burnout.

Design: RCT using two cohorts of HCWs of four NICUs each, to improve HCW well-being (primary outcome: burnout). Cohort 1 received WISER while Cohort 2 acted as a waitlist control.

Results: Cohorts were similar, mostly female (83%) and nurses (62%). In Cohorts 1 and 2 respectively, 182 and 299 initiated WISER, 100 and 176 completed 1-month follow-up, and 78 and 146 completed 6-month follow-up. Relative to control, WISER decreased burnout (-5.27 (95% CI: -10.44, -0.10), p = 0.046). Combined adjusted cohort results at 1-month showed that the percentage of HCWs reporting concerning outcomes was significantly decreased for burnout (-6.3% (95%CI: -11.6%, -1.0%); p = 0.008), and secondary outcomes depression (-5.2% (95%CI: -10.8, -0.4); p = 0.022) and work-life integration (-11.8% (95%CI: -17.9, -6.1); p < 0.001). Improvements endured at 6 months.

Conclusion: WISER appears to durably improve HCW well-being.

Clinical trials number: NCT02603133; https://clinicaltrials.gov/ct2/show/NCT02603133.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Burnout, Professional* / prevention & control
Burnout, Psychological*
Female
Health Personnel
Humans
Male

Associated data

ClinicalTrials.gov/NCT02603133

Abstract

Publication types

MeSH terms

Associated data

Grants and funding