The interplay between organizational culture and burnout among ICU professionals: A cross-sectional multicenter study
Niek Kok, Cornelia Hoedemaekers, Malaika Fuchs, Alexander D. Cornet, Esther Ewalds, Harold W. Hom, Esther Meijer, Iwan A. Meynaar, Margo van Mol, Walther van Mook, Mariëlle van der Steen-Dieperink, Arthur R. H. van Zanten, Hans van der Hoeven, Jelle van Gurp, Marieke Zegers
Abstract
Organizational culture is considered a protective factor against burnout among ICU professionals. The aim of this study is to study the association between organizational culture as a potential antecedent to previously found mediating risk factors for burnout, namely, work-life balance and moral distress. Multicenter cross sectional study in eleven Dutch ICUs. The primary outcome measure was the core symptom of burnout, emotional exhaustion, measured using the validated Dutch version of the Maslach Burnout Inventory. Organizational culture was assessed using the Culture of Care Barometer, which measures five aspects of organizational culture. Moral distress and work-life balance were measured with validated questionnaires. 696 ICU professionals (39.7 %) responded. All aspects of the CoCB were negatively associated with the emotional exhaustion component of burnout, both in univariable and multivariable models. Four aspects of organizational culture were significantly associated to the serial association between moral distress, work-to-home spillovers, and emotional exhaustion. For these aspects, the total indirect association was equal or larger than the total direct association. Multiple aspects of organizational culture reduce burnout among ICU professionals in a largely indirect manner, via moral distress and work-life balance. Improving organizational culture can mitigate burnout symptoms among ICU clinicians. • There are large difference in burnout prevalence across hospitals. • ICU organizational culture is undervalued as a factor that protects against burnout. • Organizational culture may contribute to moral distress and negative work-home balance. • strong collegial relations may, from the top down, help ICU professionals make sense of morally distressing situations. • Improving organizational culture can mitigate burnout symptoms among ICU clinicians.