Web-based Implementation for the Science of Enhancing Resilience Study

NCT ID: NCT02603133

Last Updated: 2023-02-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

2650 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-07-31

Study Completion Date

2019-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Resilience means a healthcare provider's ability to cope, recover, and learn from stressful events, as well as their access to resources that promote health and well-being. Neonatal intensive care unit (NICU) health professionals' need to have particularly good resilience, because their work is extremely stressful and their patients, fragile preterm infants, require their undivided attention. The investigators propose a feasible and engaging intervention to enhance resilience among NICU health professionals promoting their ability to provide safe care.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Optimizing provider well-being is critical to the delivery of safe and high quality care to the most vulnerable of patients: very preterm babies.

Major innovative objectives of this proposal include testing the Web-based Implementation for the Science of Enhancing Resilience (WISER) program's effectiveness in enhancing resilience among Neonatal Intensive Care Unit (NICU) health workers, evaluating its effect on unit safety culture, and examining its effect on clinical outcomes in preterm infants. The WISER program is an established but low-intensity yet engaging intervention, which integrates education and behavior modification to boost provider well-being and resilience in order to create an organizational environment which prevents patient harm.

Care for the more than 50,000 very low birth weight (VLBW; \< 1500 gm) infants born annually in the United States is challenging and expensive. Quality of care and outcomes vary widely. Increasing technical demands and patient acuity have pushed burnout among health workers to the breaking point. The few tested interventions that improve caregiver resilience lack feasibility for widespread adoption. This study is designed to achieve the following aims:

1. Test the effectiveness of WISER in improving NICU health professional resilience;
2. Test the effectiveness of WISER in improving patient safety and organizational outcomes;
3. Test the sustainability of WISER; and
4. Describe the barriers and facilitators of the WISER program.

The investigators will test the efficacy of the WISER Program in the NICU setting using a stepped-wedge mixed-methods randomized controlled trial (swRCT) at six tertiary care NICUs. The results of this trial will also provide insights into the causal relations between health worker resilience, the organizational environment, and clinical outcomes among infants born VLBW.

Two blocks with 3 NICUs each will be randomly assigned to one of two intervention cohorts. The WISER NICUs program consists of six 10-minute videos delivered over the course of a six-month period. Following the end of the initial intervention, each NICU will receive individualized feedback/refresher webinar at 12 months, and a final follow-up at 24 months. The investigators will use measures of perception (surveys of health professional's perceptions) and quantifiable measures (clinical measures) to assess the efficacy of the intervention in different domains (resilience, organizational environment, and health). Qualitative methods will provide further insights into facilitators and barriers of the efficacy of WISER.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Burnout, Professional Resilience, Psychological

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Participants are individually randomized to one of two cohorts. 1 cohort will serve as the waitlist control for Cohort 1 before starting their version of the intervention. Each cohort will experience slightly different versions of WISER, which only differ by the spacing of the intervention. Cohort 1 will receive a 10-day sequential (Seq) and a 10-day non-sequential (NSeq) rollout of the resilience tools. Seq will receive the tools on ten consecutive days. NSeq will receive messages daily with the exception of Thursdays, Fridays and Saturdays. Our tracking of attrition in the first study showed marked declines in participation on Thursdays, Fridays, and to some extent on Saturdays, but an increase on Sundays, hence this design to test a new way of counteracting attrition.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Cohort 1

The intervention will begin for all NICUs, with baseline surveys as necessary pre-work. For those unable to attend, a link to the baseline survey will be emailed with site champion instructions to complete in groups at staff meetings and during shift change. Two weeks later, three randomly (random number generator) assigned NICUs (block 1) included in the first block webinar will then receive Module 1 of the intervention with Modules 2-6 being rolled out monthly. The second block of three NICUs starts approximately six-month later.

Group Type OTHER

Three Good Things

Intervention Type BEHAVIORAL

In this tool participants reflect on "good things" that happened that day during evenings across 10 days. Participants are also able to voluntarily share their good things and read other participants' good things through the nightly anonymous log. By savoring good moments from earlier that day, participants are thought to shift from the natural focus on "what went poorly" due to negativity bias1 to an appreciation for what went well. This shift in focus is thought to reduce rumination and depression symptoms. In prior research, 3GTs was found to increase happiness and decrease depression in internet participants.2 In prior cohorts of 3GTs, we saw improvements in burnout, depression symptoms, work-life balance, and happiness. Participants also report benefiting from viewing nightly Three Good Things logs of others.

Gratitude

Intervention Type BEHAVIORAL

In this tool participants are offered the opportunity to cultivate gratitude toward others through a guided gratitude letter writing exercise.2 Through expressing gratitude, we learn more about our vital connections to others, often in surprising and meaningful ways. Previous research has found that gratitude interventions increase well-being in a number of ways, particularly in boosting positive affect.

Random Acts of Kindess

Intervention Type BEHAVIORAL

In this tool, participants report kind acts that they have committed, received, and/or witnessed, each day. By committing random acts of kindness participants experience a boost of positive emotions, and report lower negative affect. Recipients of acts of kindness benefit as well.

Awe

Intervention Type BEHAVIORAL

This tool provides participants the opportunity to recount in detail one of their own experiences of awe, and encourages them to be on the lookout for new ones (even minor examples) over a few days. When we experience awe, our sense of time expands, we are kinder to others, we experience higher life satisfaction, and we prefer experiences over material things.

1 Good Chat

Intervention Type BEHAVIORAL

This tool uses the latest research on cultivating relationships and increasing social connection. Feeling socially connected is linked to health and well-being outcomes, including longevity.6 The 1 Good Chat tool asks participants to reflect on good conversations and to note the prosocial behaviors that he/she and the other person engaged in

Cohort 2

This second block of 3 NICUs will start approximately six-months after roll-out of group 1. At time point 0 this NICUs in this group will receive a lecture on safety culture, unrelated to the burnout intervention.

Group Type OTHER

Three Good Things

Intervention Type BEHAVIORAL

In this tool participants reflect on "good things" that happened that day during evenings across 10 days. Participants are also able to voluntarily share their good things and read other participants' good things through the nightly anonymous log. By savoring good moments from earlier that day, participants are thought to shift from the natural focus on "what went poorly" due to negativity bias1 to an appreciation for what went well. This shift in focus is thought to reduce rumination and depression symptoms. In prior research, 3GTs was found to increase happiness and decrease depression in internet participants.2 In prior cohorts of 3GTs, we saw improvements in burnout, depression symptoms, work-life balance, and happiness. Participants also report benefiting from viewing nightly Three Good Things logs of others.

Gratitude

Intervention Type BEHAVIORAL

In this tool participants are offered the opportunity to cultivate gratitude toward others through a guided gratitude letter writing exercise.2 Through expressing gratitude, we learn more about our vital connections to others, often in surprising and meaningful ways. Previous research has found that gratitude interventions increase well-being in a number of ways, particularly in boosting positive affect.

Random Acts of Kindess

Intervention Type BEHAVIORAL

In this tool, participants report kind acts that they have committed, received, and/or witnessed, each day. By committing random acts of kindness participants experience a boost of positive emotions, and report lower negative affect. Recipients of acts of kindness benefit as well.

Awe

Intervention Type BEHAVIORAL

This tool provides participants the opportunity to recount in detail one of their own experiences of awe, and encourages them to be on the lookout for new ones (even minor examples) over a few days. When we experience awe, our sense of time expands, we are kinder to others, we experience higher life satisfaction, and we prefer experiences over material things.

1 Good Chat

Intervention Type BEHAVIORAL

This tool uses the latest research on cultivating relationships and increasing social connection. Feeling socially connected is linked to health and well-being outcomes, including longevity.6 The 1 Good Chat tool asks participants to reflect on good conversations and to note the prosocial behaviors that he/she and the other person engaged in

Cohort 3 (July cohort) WISER 2.0

Individually randomized to one of two cohorts. Cohort 1 to start will serve as the waitlist control 1 before starting their version of the intervention. Each cohort will experience modified versions of WISER, which only differ by the spacing of intervention. Participants will receive 10-day sequential or 10-day non-sequential rollout of the resilience tools. Seq will receive the tools on ten consecutive days. NSeq will receive messages daily noThursdays, Fridays and Saturdays.

Days 1 through 3 will be offered 3GT. Day 4 will continue with 3GT but add a single day activity for Gratitude. Day 5 adds a single activity for Awe. Day 6 adds a single day activity for RAK. Days 7 -10 the participant is offered the choice of Gratitude, Awe or RAK to accompany their daily 3GT. At 1 month follow-up time point, participants will receive 8 days of the 1 Good Chat tool, as a booster. At 6 month follow-up, participants will receive a gratitude exercise.

Group Type EXPERIMENTAL

Three Good Things

Intervention Type BEHAVIORAL

In this tool participants reflect on "good things" that happened that day during evenings across 10 days. Participants are also able to voluntarily share their good things and read other participants' good things through the nightly anonymous log. By savoring good moments from earlier that day, participants are thought to shift from the natural focus on "what went poorly" due to negativity bias1 to an appreciation for what went well. This shift in focus is thought to reduce rumination and depression symptoms. In prior research, 3GTs was found to increase happiness and decrease depression in internet participants.2 In prior cohorts of 3GTs, we saw improvements in burnout, depression symptoms, work-life balance, and happiness. Participants also report benefiting from viewing nightly Three Good Things logs of others.

Gratitude

Intervention Type BEHAVIORAL

In this tool participants are offered the opportunity to cultivate gratitude toward others through a guided gratitude letter writing exercise.2 Through expressing gratitude, we learn more about our vital connections to others, often in surprising and meaningful ways. Previous research has found that gratitude interventions increase well-being in a number of ways, particularly in boosting positive affect.

Random Acts of Kindess

Intervention Type BEHAVIORAL

In this tool, participants report kind acts that they have committed, received, and/or witnessed, each day. By committing random acts of kindness participants experience a boost of positive emotions, and report lower negative affect. Recipients of acts of kindness benefit as well.

Awe

Intervention Type BEHAVIORAL

This tool provides participants the opportunity to recount in detail one of their own experiences of awe, and encourages them to be on the lookout for new ones (even minor examples) over a few days. When we experience awe, our sense of time expands, we are kinder to others, we experience higher life satisfaction, and we prefer experiences over material things.

1 Good Chat

Intervention Type BEHAVIORAL

This tool uses the latest research on cultivating relationships and increasing social connection. Feeling socially connected is linked to health and well-being outcomes, including longevity.6 The 1 Good Chat tool asks participants to reflect on good conversations and to note the prosocial behaviors that he/she and the other person engaged in

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Three Good Things

In this tool participants reflect on "good things" that happened that day during evenings across 10 days. Participants are also able to voluntarily share their good things and read other participants' good things through the nightly anonymous log. By savoring good moments from earlier that day, participants are thought to shift from the natural focus on "what went poorly" due to negativity bias1 to an appreciation for what went well. This shift in focus is thought to reduce rumination and depression symptoms. In prior research, 3GTs was found to increase happiness and decrease depression in internet participants.2 In prior cohorts of 3GTs, we saw improvements in burnout, depression symptoms, work-life balance, and happiness. Participants also report benefiting from viewing nightly Three Good Things logs of others.

Intervention Type BEHAVIORAL

Gratitude

In this tool participants are offered the opportunity to cultivate gratitude toward others through a guided gratitude letter writing exercise.2 Through expressing gratitude, we learn more about our vital connections to others, often in surprising and meaningful ways. Previous research has found that gratitude interventions increase well-being in a number of ways, particularly in boosting positive affect.

Intervention Type BEHAVIORAL

Random Acts of Kindess

In this tool, participants report kind acts that they have committed, received, and/or witnessed, each day. By committing random acts of kindness participants experience a boost of positive emotions, and report lower negative affect. Recipients of acts of kindness benefit as well.

Intervention Type BEHAVIORAL

Awe

This tool provides participants the opportunity to recount in detail one of their own experiences of awe, and encourages them to be on the lookout for new ones (even minor examples) over a few days. When we experience awe, our sense of time expands, we are kinder to others, we experience higher life satisfaction, and we prefer experiences over material things.

Intervention Type BEHAVIORAL

1 Good Chat

This tool uses the latest research on cultivating relationships and increasing social connection. Feeling socially connected is linked to health and well-being outcomes, including longevity.6 The 1 Good Chat tool asks participants to reflect on good conversations and to note the prosocial behaviors that he/she and the other person engaged in

Intervention Type BEHAVIORAL

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

3GT Tool Grat Tool RAK Tool Awe Tool Good Chat Tool

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Location: newborn center, i.e. the NICU or a step down unit
2. Provider:

1. Primary work place is the Newborn Center
2. Full time equivalent of \>=40%
3. Date of hire more than 4 weeks prior to start of the intervention
3. Provider groups:

1. Attendings that identify your newborn center as their primary site of work (not physicians from satellite NICUs)
2. NICU fellows
3. Nurse practitioners
4. Physician Assistants
5. Nurses, including nurse leadership (managers, educators)
6. Nurse Assistant
7. Respiratory care providers
8. Transport specialists if primarily neonatal transport team
9. Newborn Center Social workers
10. Newborn Center Clerks
11. Newborn Center Pharmacists
12. Newborn Center Physical, Occupational, Speech, and Developmental Therapists
13. Newborn Center Nutritionists
14. Newborn Center Lactation Consultants

Exclusion Criteria

1. Location: Labor and delivery or the newborn nursery
2. Provider: Work is delivered mostly outside the newborn center (this may affect providers who delivery services across the hospital such as residents, surgeons, anesthesia, consultants, nutritionists, PT/OT (these are included if they are mostly dedicated to the newborn center)
3. Float personnel
4. Does not speak english
5. Cannot operate computer or smart phone
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Jochen Profit

Associate Professor of Pediatrics, Director of Perinatal Health Systems Research

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Jochen Profit, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Stanford University

J. Bryan Sexton, PhD

Role: PRINCIPAL_INVESTIGATOR

Duke University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Lucile Packard Children's Hospital at Stanford

Palo Alto, California, United States

Site Status

Stanford University Medical Center

Stanford, California, United States

Site Status

Beth Israel Deconness Medical Center

Boston, Massachusetts, United States

Site Status

University of New Mexico

Albuquerque, New Mexico, United States

Site Status

University of North Carolina at Chapel Hill Children's Hospital

Chapel Hill, North Carolina, United States

Site Status

Duke University Health System

Durham, North Carolina, United States

Site Status

Vanderbilt University

Nashville, Tennessee, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

University of Texas, Houston

Houston, Texas, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Dyrbye LN, Shanafelt TD. Physician burnout: a potential threat to successful health care reform. JAMA. 2011 May 18;305(19):2009-10. doi: 10.1001/jama.2011.652. No abstract available.

Reference Type BACKGROUND
PMID: 21586718 (View on PubMed)

Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, Bruyneel L, Rafferty AM, Griffiths P, Moreno-Casbas MT, Tishelman C, Scott A, Brzostek T, Kinnunen J, Schwendimann R, Heinen M, Zikos D, Sjetne IS, Smith HL, Kutney-Lee A. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ. 2012 Mar 20;344:e1717. doi: 10.1136/bmj.e1717.

Reference Type BACKGROUND
PMID: 22434089 (View on PubMed)

West CP, Tan AD, Shanafelt TD. Association of resident fatigue and distress with occupational blood and body fluid exposures and motor vehicle incidents. Mayo Clin Proc. 2012 Dec;87(12):1138-44. doi: 10.1016/j.mayocp.2012.07.021.

Reference Type BACKGROUND
PMID: 23218084 (View on PubMed)

Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, Edwards S, Wiedermann BL, Landrigan CP. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008 Mar 1;336(7642):488-91. doi: 10.1136/bmj.39469.763218.BE. Epub 2008 Feb 7.

Reference Type BACKGROUND
PMID: 18258931 (View on PubMed)

Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, Roberts PR, Thomas EJ. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006 Apr 3;6:44. doi: 10.1186/1472-6963-6-44.

Reference Type BACKGROUND
PMID: 16584553 (View on PubMed)

Profit J, Sharek PJ, Amspoker AB, Kowalkowski MA, Nisbet CC, Thomas EJ, Chadwick WA, Sexton JB. Burnout in the NICU setting and its relation to safety culture. BMJ Qual Saf. 2014 Oct;23(10):806-13. doi: 10.1136/bmjqs-2014-002831. Epub 2014 Apr 17.

Reference Type BACKGROUND
PMID: 24742780 (View on PubMed)

Sexton JB, Sharek PJ, Thomas EJ, Gould JB, Nisbet CC, Amspoker AB, Kowalkowski MA, Schwendimann R, Profit J. Exposure to Leadership WalkRounds in neonatal intensive care units is associated with a better patient safety culture and less caregiver burnout. BMJ Qual Saf. 2014 Oct;23(10):814-22. doi: 10.1136/bmjqs-2013-002042. Epub 2014 May 13.

Reference Type BACKGROUND
PMID: 24825895 (View on PubMed)

van Wyk BE, Pillay-Van Wyk V. Preventive staff-support interventions for health workers. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD003541. doi: 10.1002/14651858.CD003541.pub2.

Reference Type BACKGROUND
PMID: 20238322 (View on PubMed)

Sexton JB, Chadwick WA, Weiss KJ, Clarke A, Gould JB, Profit J. Assessing and Improving Health Care Worker Resilience in the NICU. E-PAS 2013:4150.7

Reference Type BACKGROUND

Ungar M. Researching and theorizing resilience across cultures and contexts. Prev Med. 2012 Nov;55(5):387-9. doi: 10.1016/j.ypmed.2012.07.021. Epub 2012 Aug 1. No abstract available.

Reference Type BACKGROUND
PMID: 22884666 (View on PubMed)

Maslach C, Jackson SE. Maslach Burnout Inventory. Palo Alto, CA: Consulting Psychologists Press, Inc.; 1981

Reference Type BACKGROUND

Profit J, Gould JB, Zupancic JA, Stark AR, Wall KM, Kowalkowski MA, Mei M, Pietz K, Thomas EJ, Petersen LA. Formal selection of measures for a composite index of NICU quality of care: Baby-MONITOR. J Perinatol. 2011 Nov;31(11):702-10. doi: 10.1038/jp.2011.12. Epub 2011 Feb 24.

Reference Type BACKGROUND
PMID: 21350429 (View on PubMed)

Ahola K, Vaananen A, Koskinen A, Kouvonen A, Shirom A. Burnout as a predictor of all-cause mortality among industrial employees: a 10-year prospective register-linkage study. J Psychosom Res. 2010 Jul;69(1):51-7. doi: 10.1016/j.jpsychores.2010.01.002. Epub 2010 Mar 19.

Reference Type BACKGROUND
PMID: 20630263 (View on PubMed)

Kitaoka-Higashiguchi K, Morikawa Y, Miura K, Sakurai M, Ishizaki M, Kido T, Naruse Y, Nakagawa H. Burnout and risk factors for arteriosclerotic disease: follow-up study. J Occup Health. 2009;51(2):123-31. doi: 10.1539/joh.l8104. Epub 2009 Feb 10.

Reference Type BACKGROUND
PMID: 19212087 (View on PubMed)

Guest RS, Baser R, Li Y, Scardino PT, Brown AE, Kissane DW. Cancer surgeons' distress and well-being, II: modifiable factors and the potential for organizational interventions. Ann Surg Oncol. 2011 May;18(5):1236-42. doi: 10.1245/s10434-011-1623-5. Epub 2011 Mar 12.

Reference Type BACKGROUND
PMID: 21399883 (View on PubMed)

Campbell DA Jr, Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ. Burnout among American surgeons. Surgery. 2001 Oct;130(4):696-702; discussion 702-5. doi: 10.1067/msy.2001.116676.

Reference Type BACKGROUND
PMID: 11602901 (View on PubMed)

Geurts S, Rutte C, Peeters M. Antecedents and consequences of work-home interference among medical residents. Soc Sci Med. 1999 May;48(9):1135-48. doi: 10.1016/s0277-9536(98)00425-0.

Reference Type BACKGROUND
PMID: 10220015 (View on PubMed)

Mealer M, Burnham EL, Goode CJ, Rothbaum B, Moss M. The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depress Anxiety. 2009;26(12):1118-26. doi: 10.1002/da.20631.

Reference Type BACKGROUND
PMID: 19918928 (View on PubMed)

Demir Zencirci A, Arslan S. Morning-evening type and burnout level as factors influencing sleep quality of shift nurses: a questionnaire study. Croat Med J. 2011 Aug 15;52(4):527-37. doi: 10.3325/cmj.2011.52.527.

Reference Type BACKGROUND
PMID: 21853548 (View on PubMed)

Zhang Y, Feng X. The relationship between job satisfaction, burnout, and turnover intention among physicians from urban state-owned medical institutions in Hubei, China: a cross-sectional study. BMC Health Serv Res. 2011 Sep 24;11:235. doi: 10.1186/1472-6963-11-235.

Reference Type BACKGROUND
PMID: 21943042 (View on PubMed)

Shelledy DC, Mikles SP, May DF, Youtsey JW. Analysis of job satisfaction, burnout, and intent of respiratory care practitioners to leave the field or the job. Respir Care. 1992 Jan;37(1):46-60.

Reference Type BACKGROUND
PMID: 10145581 (View on PubMed)

Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002 Mar 5;136(5):358-67. doi: 10.7326/0003-4819-136-5-200203050-00008.

Reference Type BACKGROUND
PMID: 11874308 (View on PubMed)

Meeusen VC, Van Dam K, Brown-Mahoney C, Van Zundert AA, Knape HT. Understanding nurse anesthetists' intention to leave their job: how burnout and job satisfaction mediate the impact of personality and workplace characteristics. Health Care Manage Rev. 2011 Apr-Jun;36(2):155-63. doi: 10.1097/HMR.0b013e3181fb0f41.

Reference Type BACKGROUND
PMID: 21317664 (View on PubMed)

McMurray JE, Linzer M, Konrad TR, Douglas J, Shugerman R, Nelson K. The work lives of women physicians results from the physician work life study. The SGIM Career Satisfaction Study Group. J Gen Intern Med. 2000 Jun;15(6):372-80. doi: 10.1111/j.1525-1497.2000.im9908009.x.

Reference Type BACKGROUND
PMID: 10886471 (View on PubMed)

West CP, Huschka MM, Novotny PJ, Sloan JA, Kolars JC, Habermann TM, Shanafelt TD. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006 Sep 6;296(9):1071-8. doi: 10.1001/jama.296.9.1071.

Reference Type BACKGROUND
PMID: 16954486 (View on PubMed)

Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, Collicott P, Novotny PJ, Sloan J, Freischlag J. Burnout and medical errors among American surgeons. Ann Surg. 2010 Jun;251(6):995-1000. doi: 10.1097/SLA.0b013e3181bfdab3.

Reference Type BACKGROUND
PMID: 19934755 (View on PubMed)

Prins JT, van der Heijden FM, Hoekstra-Weebers JE, Bakker AB, van de Wiel HB, Jacobs B, Gazendam-Donofrio SM. Burnout, engagement and resident physicians' self-reported errors. Psychol Health Med. 2009 Dec;14(6):654-66. doi: 10.1080/13548500903311554.

Reference Type BACKGROUND
PMID: 20183538 (View on PubMed)

Rochefort CM, Clarke SP. Nurses' work environments, care rationing, job outcomes, and quality of care on neonatal units. J Adv Nurs. 2010 Oct;66(10):2213-24. doi: 10.1111/j.1365-2648.2010.05376.x. Epub 2010 Jul 2.

Reference Type BACKGROUND
PMID: 20626479 (View on PubMed)

Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002 Oct 23-30;288(16):1987-93. doi: 10.1001/jama.288.16.1987.

Reference Type BACKGROUND
PMID: 12387650 (View on PubMed)

Cherniss C. Staff Burnout: Job Stress in the Human Services. Beverly Hills, CA: Sage Publications; 1980

Reference Type BACKGROUND

Bellieni CV, Righetti P, Ciampa R, Iacoponi F, Coviello C, Buonocore G. Assessing burnout among neonatologists. J Matern Fetal Neonatal Med. 2012 Oct;25(10):2130-4. doi: 10.3109/14767058.2012.666590. Epub 2012 May 10.

Reference Type BACKGROUND
PMID: 22571319 (View on PubMed)

Shanafelt TD, Balch CM, Bechamps GJ, Russell T, Dyrbye L, Satele D, Collicott P, Novotny PJ, Sloan J, Freischlag JA. Burnout and career satisfaction among American surgeons. Ann Surg. 2009 Sep;250(3):463-71. doi: 10.1097/SLA.0b013e3181ac4dfd.

Reference Type BACKGROUND
PMID: 19730177 (View on PubMed)

Cimiotti JP, Aiken LH, Sloane DM, Wu ES. Nurse staffing, burnout, and health care-associated infection. Am J Infect Control. 2012 Aug;40(6):486-90. doi: 10.1016/j.ajic.2012.02.029.

Reference Type BACKGROUND
PMID: 22854376 (View on PubMed)

Sexton JB, Berenholtz SM, Goeschel CA, Watson SR, Holzmueller CG, Thompson DA, Hyzy RC, Marsteller JA, Schumacher K, Pronovost PJ. Assessing and improving safety climate in a large cohort of intensive care units. Crit Care Med. 2011 May;39(5):934-9. doi: 10.1097/CCM.0b013e318206d26c.

Reference Type BACKGROUND
PMID: 21297460 (View on PubMed)

Marsteller JA, Sexton JB, Hsu YJ, Hsiao CJ, Holzmueller CG, Pronovost PJ, Thompson DA. A multicenter, phased, cluster-randomized controlled trial to reduce central line-associated bloodstream infections in intensive care units*. Crit Care Med. 2012 Nov;40(11):2933-9. doi: 10.1097/CCM.0b013e31825fd4d8.

Reference Type BACKGROUND
PMID: 22890251 (View on PubMed)

Marshall RE, Kasman C. Burnout in the neonatal intensive care unit. Pediatrics. 1980 Jun;65(6):1161-5.

Reference Type BACKGROUND
PMID: 7375242 (View on PubMed)

Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, Mooney CJ, Quill TE. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009 Sep 23;302(12):1284-93. doi: 10.1001/jama.2009.1384.

Reference Type BACKGROUND
PMID: 19773563 (View on PubMed)

McCray LW, Cronholm PF, Bogner HR, Gallo JJ, Neill RA. Resident physician burnout: is there hope? Fam Med. 2008 Oct;40(9):626-32.

Reference Type BACKGROUND
PMID: 18830837 (View on PubMed)

Rowe MM. Teaching health-care providers coping: results of a two-year study. J Behav Med. 1999 Oct;22(5):511-27. doi: 10.1023/a:1018661508593.

Reference Type BACKGROUND
PMID: 10586384 (View on PubMed)

West CP, Dyrbye LN, Rabatin JT, Call TG, Davidson JH, Multari A, Romanski SA, Hellyer JM, Sloan JA, Shanafelt TD. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014 Apr;174(4):527-33. doi: 10.1001/jamainternmed.2013.14387.

Reference Type BACKGROUND
PMID: 24515493 (View on PubMed)

Sin NL, Lyubomirsky S. Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: a practice-friendly meta-analysis. J Clin Psychol. 2009 May;65(5):467-87. doi: 10.1002/jclp.20593.

Reference Type BACKGROUND
PMID: 19301241 (View on PubMed)

Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, Sexton B, Hyzy R, Welsh R, Roth G, Bander J, Kepros J, Goeschel C. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006 Dec 28;355(26):2725-32. doi: 10.1056/NEJMoa061115.

Reference Type BACKGROUND
PMID: 17192537 (View on PubMed)

Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985 Sep;98(2):310-57. No abstract available.

Reference Type BACKGROUND
PMID: 3901065 (View on PubMed)

Brown C, Hofer T, Johal A, Thomson R, Nicholl J, Franklin BD, Lilford RJ. An epistemology of patient safety research: a framework for study design and interpretation. Part 2. Study design. Qual Saf Health Care. 2008 Jun;17(3):163-9. doi: 10.1136/qshc.2007.023648.

Reference Type BACKGROUND
PMID: 18519621 (View on PubMed)

Hussey MA, Hughes JP. Design and analysis of stepped wedge cluster randomized trials. Contemp Clin Trials. 2007 Feb;28(2):182-91. doi: 10.1016/j.cct.2006.05.007. Epub 2006 Jul 7.

Reference Type BACKGROUND
PMID: 16829207 (View on PubMed)

Kao LS, Lew DF, Doyle PD, Carrick MM, Jordan VS, Thomas EJ, Lally KP. A tale of 2 hospitals: a staggered cohort study of targeted interventions to improve compliance with antibiotic prophylaxis guidelines. Surgery. 2010 Aug;148(2):255-62. doi: 10.1016/j.surg.2010.04.003. Epub 2010 May 21.

Reference Type BACKGROUND
PMID: 20494387 (View on PubMed)

Profit J, Zupancic JA, Gould JB, Pietz K, Kowalkowski MA, Draper D, Hysong SJ, Petersen LA. Correlation of neonatal intensive care unit performance across multiple measures of quality of care. JAMA Pediatr. 2013 Jan;167(1):47-54. doi: 10.1001/jamapediatrics.2013.418.

Reference Type BACKGROUND
PMID: 23403539 (View on PubMed)

Profit J, Kowalkowski MA, Zupancic JA, Pietz K, Richardson P, Draper D, Hysong SJ, Thomas EJ, Petersen LA, Gould JB. Baby-MONITOR: a composite indicator of NICU quality. Pediatrics. 2014 Jul;134(1):74-82. doi: 10.1542/peds.2013-3552. Epub 2014 Jun 2.

Reference Type BACKGROUND
PMID: 24918221 (View on PubMed)

Jarvis P. Adult Education and Lifelong Learning: Theory and Practice. 4th ed. New York, NY: Routledge; 2010

Reference Type BACKGROUND

Profit J, Etchegaray J, Petersen LA, Sexton JB, Hysong SJ, Mei M, Thomas EJ. Neonatal intensive care unit safety culture varies widely. Arch Dis Child Fetal Neonatal Ed. 2012 Mar;97(2):F120-6. doi: 10.1136/archdischild-2011-300635. Epub 2011 Sep 19.

Reference Type BACKGROUND
PMID: 21930691 (View on PubMed)

Edwards D, Burnard P, Coyle D, Fothergill A, Hannigan B. A stepwise multivariate analysis of factors that contribute to stress for mental health nurses working in the community. J Adv Nurs. 2001 Dec;36(6):805-13. doi: 10.1046/j.1365-2648.2001.02035.x.

Reference Type BACKGROUND
PMID: 11903710 (View on PubMed)

Kohout FJ, Berkman LF, Evans DA, Cornoni-Huntley J. Two shorter forms of the CES-D (Center for Epidemiological Studies Depression) depression symptoms index. J Aging Health. 1993 May;5(2):179-93. doi: 10.1177/089826439300500202.

Reference Type BACKGROUND
PMID: 10125443 (View on PubMed)

Pennebaker JW, Colder M, Sharp LK. Accelerating the coping process. J Pers Soc Psychol. 1990 Mar;58(3):528-537. doi: 10.1037//0022-3514.58.3.528.

Reference Type BACKGROUND
PMID: 2324942 (View on PubMed)

Vogus TJ, Sutcliffe KM. The impact of safety organizing, trusted leadership, and care pathways on reported medication errors in hospital nursing units. Med Care. 2007 Oct;45(10):997-1002. doi: 10.1097/MLR.0b013e318053674f.

Reference Type BACKGROUND
PMID: 17890998 (View on PubMed)

Profit J, Etchegaray J, Petersen LA, Sexton JB, Hysong SJ, Mei M, Thomas EJ. The Safety Attitudes Questionnaire as a tool for benchmarking safety culture in the NICU. Arch Dis Child Fetal Neonatal Ed. 2012 Mar;97(2):F127-32. doi: 10.1136/archdischild-2011-300612.

Reference Type BACKGROUND
PMID: 22337935 (View on PubMed)

Profit J, Weiss K, Clarke A, Gest AL, Sexton JB. NICU Caregiver Burnout, Happiness, and Three Good Things. Pediatric Academic Societies' Annual Meeting 2014;E-PAS 3844.652

Reference Type BACKGROUND

Maslach C, Jackson S. The measurement of experienced burnout. J Occ Behav 1981;2:99-113

Reference Type BACKGROUND

Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397-422. doi: 10.1146/annurev.psych.52.1.397.

Reference Type BACKGROUND
PMID: 11148311 (View on PubMed)

Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, Menaker R, Rummans TA, Dyrbye LN. Career fit and burnout among academic faculty. Arch Intern Med. 2009 May 25;169(10):990-5. doi: 10.1001/archinternmed.2009.70.

Reference Type BACKGROUND
PMID: 19468093 (View on PubMed)

Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994 Mar-Apr;10(2):77-84.

Reference Type BACKGROUND
PMID: 8037935 (View on PubMed)

Lyubomirsky S, Ross L. Changes in attractiveness of elected, rejected, and precluded alternatives: a comparison of happy and unhappy individuals. J Pers Soc Psychol. 1999 Jun;76(6):988-1007. doi: 10.1037//0022-3514.76.6.988.

Reference Type BACKGROUND
PMID: 10402682 (View on PubMed)

Howell RT, Rodzon KS, Kurai M, Sanchez AH. A validation of well-being and happiness surveys for administration via the Internet. Behav Res Methods. 2010 Aug;42(3):775-84. doi: 10.3758/BRM.42.3.775.

Reference Type BACKGROUND
PMID: 20805600 (View on PubMed)

Hudson DW, Berenholtz SM, Thomas EJ, Sexton BJ. A safety culture primer for the critical care clinician: the role of culture in patient safety and quality improvement. Contemp Crit Care 2009;7:1-12

Reference Type BACKGROUND

Pronovost P, Weast B. Implementing and validating a comprehensive unit-based safety program. J Patient Saf 2005:33-40

Reference Type BACKGROUND

Pettker CM, Thung SF, Norwitz ER, Buhimschi CS, Raab CA, Copel JA, Kuczynski E, Lockwood CJ, Funai EF. Impact of a comprehensive patient safety strategy on obstetric adverse events. Am J Obstet Gynecol. 2009 May;200(5):492.e1-8. doi: 10.1016/j.ajog.2009.01.022. Epub 2009 Feb 27.

Reference Type BACKGROUND
PMID: 19249729 (View on PubMed)

Wolf FA, Way LW, Stewart L. The efficacy of medical team training: improved team performance and decreased operating room delays: a detailed analysis of 4863 cases. Ann Surg. 2010 Sep;252(3):477-83; discussion 483-5. doi: 10.1097/SLA.0b013e3181f1c091.

Reference Type BACKGROUND
PMID: 20739848 (View on PubMed)

Pronovost PJ, Berenholtz SM, Goeschel C, Thom I, Watson SR, Holzmueller CG, Lyon JS, Lubomski LH, Thompson DA, Needham D, Hyzy R, Welsh R, Roth G, Bander J, Morlock L, Sexton JB. Improving patient safety in intensive care units in Michigan. J Crit Care. 2008 Jun;23(2):207-21. doi: 10.1016/j.jcrc.2007.09.002.

Reference Type BACKGROUND
PMID: 18538214 (View on PubMed)

Profit J, Sexton JB, Thomas EJ, et al. Higher Safety Culture among Neonatal Intensive Care Units That Participate in Quality Improvement Collaboratives. E-PAS 2012:2920.350

Reference Type BACKGROUND

Profit J, Lee HC, Sharek PJ, et al. NICU Safety Culture: The Effect of Choice of Instrument on Benchmarking. Pediatrics 2014;Under review

Reference Type BACKGROUND

Profit J, Typpo KV, Hysong SJ, Woodard LD, Kallen MA, Petersen LA. Improving benchmarking by using an explicit framework for the development of composite indicators: an example using pediatric quality of care. Implement Sci. 2010 Feb 9;5:13. doi: 10.1186/1748-5908-5-13.

Reference Type BACKGROUND
PMID: 20181129 (View on PubMed)

Sexton JB, Sharek PJ, Gould JB, et al. Prevalence of Emotional Exhaustion in a Cohort of 21 Neonatal Intensive Care Units. E-PAS 2012:2920.351

Reference Type BACKGROUND

Profit J, Sharek PJ, Thomas EJ, et al. Clinical Outcomes among VLBW Infants and the Links to Subsequent Perceptions of NICU Safety Culture. E-PAS 2013:2922.356

Reference Type BACKGROUND

Chadwick WA, Fullwood C, Mullin L, Browning B, Schifer C, Pietrusik J. Webinar Implementation for the Science of Enhancing Resilience (WISER): the development and evaluation of WISER 1.0. Duke University Medical School Research Day. Durham, NC2012

Reference Type BACKGROUND

Timmel J, Kent PS, Holzmueller CG, Paine L, Schulick RD, Pronovost PJ. Impact of the Comprehensive Unit-based Safety Program (CUSP) on safety culture in a surgical inpatient unit. Jt Comm J Qual Patient Saf. 2010 Jun;36(6):252-60. doi: 10.1016/s1553-7250(10)36040-5.

Reference Type BACKGROUND
PMID: 20564886 (View on PubMed)

Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol. 2005 Jul-Aug;60(5):410-21. doi: 10.1037/0003-066X.60.5.410.

Reference Type BACKGROUND
PMID: 16045394 (View on PubMed)

Emmons RA, McCullough ME. Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. J Pers Soc Psychol. 2003 Feb;84(2):377-89. doi: 10.1037//0022-3514.84.2.377.

Reference Type BACKGROUND
PMID: 12585811 (View on PubMed)

Profit J, Adair KC, Cui X, Mitchell B, Brandon D, Tawfik DS, Rigdon J, Gould JB, Lee HC, Timpson WL, McCaffrey MJ, Davis AS, Pammi M, Matthews M, Stark AR, Papile LA, Thomas E, Cotten M, Khan A, Sexton JB. 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.

Reference Type RESULT
PMID: 34366432 (View on PubMed)

Profit J, Cui X, Tawfik D, Adair KC, Sexton JB. "WISER" intervention to reduce healthcare worker burnout - 1 year follow up. J Perinatol. 2024 Dec;44(12):1719-1723. doi: 10.1038/s41372-024-01993-5. Epub 2024 May 11.

Reference Type DERIVED
PMID: 38734802 (View on PubMed)

Sexton JB, Adair KC, Cui X, Tawfik DS, Profit J. Effectiveness of a bite-sized web-based intervention to improve healthcare worker wellbeing: A randomized clinical trial of WISER. Front Public Health. 2022 Dec 8;10:1016407. doi: 10.3389/fpubh.2022.1016407. eCollection 2022.

Reference Type DERIVED
PMID: 36568789 (View on PubMed)

Kunzler AM, Helmreich I, Chmitorz A, Konig J, Binder H, Wessa M, Lieb K. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst Rev. 2020 Jul 5;7(7):CD012527. doi: 10.1002/14651858.CD012527.pub2.

Reference Type DERIVED
PMID: 32627860 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

R01HD084679

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB-34547

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Pediatrician Wellbeing Program
NCT04805294 COMPLETED