Burnout among healthcare professionals, especially in ICUs, is marked by emotional exhaustion, depersonalisation, and reduced personal accomplishment, significantly impacting staff well-being and patient care. It leads to decreased job satisfaction, higher turnover rates, recruitment challenges, and poor team dynamics, which can compromise patient outcomes. Burnout is also linked to medical errors, lower patient satisfaction, and increased morbidity and mortality.
Addressing burnout requires a comprehensive approach involving prevention, early recognition, intervention, and resilience-building. Strategies include creating supportive work environments, offering stress management resources, and implementing resilience training. This proactive approach improves staff well-being, enhances patient care, and mitigates staffing shortages.
The HELLO Trial aims to foster positive communication habits among ICU staff to improve behavioural interactions, enhance the work environment, and support the psychological well-being of healthcare workers. By promoting a collaborative culture, the project seeks to enhance patient care and reduce burnout. It also introduces best relational practices and evaluates their impact as part of an "educational research" initiative. The trial's habits are designed to have lasting effects, with the potential for global adoption if successful. Additionally, it creates an international platform for ICU professionals to exchange ideas and improve care interventions.
Few interventional studies have effectively prevented or mitigated burnout among healthcare professionals, with previous research showing only small reductions in burnout. A steering committee from the European Society of Intensive Care Medicine (ESICM) designed a globally feasible intervention to address burnout in ICUs. After considering organisational, individual, systemic, and technical approaches, they chose an organisational intervention focused on improving teamwork and communication. This intervention, called the "Hello Bundle," aims to foster positive social interactions and create a supportive work environment through simple, cost-effective strategies adaptable to various settings.
The "Hello Bundle" is a 6-part intervention designed to improve ICU workplace dynamics by fostering positive interactions, drawn from social psychology, positive psychology, and healthcare communication research. It aims to reshape healthcare professionals' behaviours by reinforcing social norms like greetings, praise, and positive feedback, which are key to building trust and cohesion in high-stress environments like ICUs. Positive emotions and effective communication are central to the intervention, promoting resilience, well-being, and teamwork.
The components include Hello campaign posters, email reminders, morning huddles, a Hello jar, lead-by-example behaviours and a Hello board. The intervention is expected to reduce burnout, improve job satisfaction, and foster a positive work environment, leading to lower turnover rates among ICU staff.
The primary objective of the HELLO Bundle study is to assess its effect on reducing burnout among ICU healthcare professionals. The primary outcome is the proportion of HCPs experiencing burnout post-intervention in both intervention and control groups. Secondary outcomes include comparing clusters on: emotional exhaustion, depersonalisation, loss of accomplishment, ethical climate perception, job satisfaction, professional conflicts, intention to leave the ICU, and ratings of patient- and family-centred care. The study will also compare burnout rates in the intervention group before and after the intervention, using HCP reports collected within four weeks pre-and post-intervention.
The trial involves 73 clusters and approximately 7,300 participants. Intervention clusters will implement the 6-component Hello Bundle from October 14 to November 10, 2024, while control clusters will be wait-listed until January 2025. Clusters are matched by ICU size, region, and average 2023 mortality.
This is the first large-scale trial combining healthcare communication, social, and positive psychology interventions for ICU healthcare professionals. It aims to provide valuable insights into effective strategies for reducing burnout in ICU settings, with the potential to improve both healthcare professionals' well-being and patient care.
Source: LIVES2024; Intensive Care Medicine
Image and Poster Credit: ESICM
