Assessment of burnout after implementation of Stress Hardiness Program in pediatric healthcare system

Background: Occupational stress in pediatric healthcare workers is not well studied. Initial assessment of burnout was done in the summer of 2010 at a children's hospital in Texas. A Stress Hardiness Program (SHP) was launched in the summer of 2010 and additional components were added throughout the next 18 months. Components of the SHP are Critical Incident Stress Management, yoga, relaxation classes, tranquility rooms, workshops on grief in the workplace, and emotional intelligence courses. Objective: Reassess the burnout scores for comparison to summer 2010 scores to evaluate SHP. Methods: We utilized the Maslach Burnout Inventory (MBI) and the Copenhagen Burnout Inventory (CBI) for burnout measurement. The MBI assessed emotional exhaustion, depersonalization, and personal accomplishment. The CBI evaluated personal, work and client-related burnout. Participants were randomly and proportionally (~10%) selected from across the six companies of hospital system. Results: 409 participants were mailed surveys, 145 returned the surveys (35.4%). MBI scores indicated 16.8% have high emotional exhaustion, 3.5% have high depersonalization, and 14.7% have low level of personal accomplishment. CBI scores demonstrated that work-burnout (38.4 vs. 37.0), client-burnout (23.5 vs. 20.3), and personal-burnout (37.2 vs. 34.2) were not significantly different from pre-assessment (p > 0.05). 128 participants (88.3%) were involved in at least one activity implemented by SHP. Conclusion: The lack of change in burnout scores was unexpected but it is possible that without the SHP burnout could be elevated higher. Confounding factors include system reorganization, explosive growth, electronic medical record implementation, and a pandemic flu outbreak within the same period.