Fostering Resilience: The Role of Team Dynamics in Mitigating Burnout and Enhancing Well-being in the Neurocritical Care Unit
Vishank Shah1, Junaid Ansari1, Miriam Quinlan1, Karissa Dushel1, Elizabeth Zink1, Jessica Jenkins1, Shirley Anderson1, Sung-Min Cho1, Susanne Muehlschlegel1, Salia Farrokh1, David Herring1, Shawn Trautman1, Rachel Bartock1, Jessica Bienstock1, Jose Suarez1
1Johns Hopkins University School of Medicine
Objective:
Staff in neurocritical care unit (NCCU) are particularly vulnerable to burnout, negatively affecting team dynamics and patient care, after the COVID-19 pandemic. We evaluated the impact of several stakeholder-led resilience-building interventions on staff burnout, team dynamics and trainee educational outcomes in the NCCU.
Background:
Burnout in neurocritical care units (NCCU) is an important and under-reported issue, marked by emotional exhaustion, depersonalization, and reduced professional accomplishment. The COVID-19 pandemic exacerbated these challenges, straining healthcare resources, and increasing stress levels.
Design/Methods:
Our study design was a participatory, stakeholder-led quality improvement intervention-based study with serial cross-sectional surveys. A multidisciplinary working group identified key drivers of burnout and impaired team dynamics and implemented interventions targeting individual and organizational resilience between December 2023 and September 2024. Strategies included a shared vision statement, zero-tolerance pledge for unprofessional behavior, enhanced leadership communication, recognition mechanisms, team-building professional development sessions and social events, workflow revisions, and restructuring of educational programs.
Results:
Surveys were conducted pre-intervention (T0), 6 (T6) and 12 months (T12) post-intervention using the Maslach Burnout Inventory and Team Dynamics (derived from Wellbeing Index) surveys. The average survey response rate was
65% 53% nurses, 20% faculty, 9% fellows, 18% APPs/pharmacists/ancillary staff) . Between T0 and T12, high emotional exhaustion decreased by 43%, depersonalization by 27%, and personal accomplishment increased by 25% (all p<0.05). Team trust/collaboration, workplace wellbeing prioritization, and personal contribution to team dynamics/wellbeing also improved significantly (all p<0.001). Mean in-service exam scores for fellows increased significantly between 2024 and 2025 (+14%, p<0.001), post-intervention.
Conclusions:
A participatory, stakeholder-driven quality improvement initiative with multi-pronged interventions targeting resilience and team dynamics reduced burnout, improved team well-being, and enhanced education in high-acuity NCCUs. This framework is feasible, sustainable, and adaptable to other ICU environments.
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