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Ischemic Stroke
Original research
Influence of thrombectomy volume on non-physician staff burnout and attrition in neurointerventional teams
  1. Kyle M Fargen1,
  2. Sameer A Ansari2,
  3. Alejandro Spiotta3,
  4. Guilherme Dabus4,
  5. Maxim Mokin5,
  6. Patrick Brown6,
  7. Stacey Q Wolfe7,
  8. Carol Kittel8,
  9. Peter Kan9,
  10. Blaise W Baxter10,
  11. Reade De Leacy11,
  12. James Milburn12,
  13. Stephan A Munich13,
  14. Andrew F Ducruet14,
  15. Alan Reeves15,
  16. Justin F Fraser16,
  17. Robert M Starke17,
  18. Ashutosh P Jadhav18,
  19. William J Mack19,
  20. Adam S Arthur20,21,
  21. Lee Pride22,
  22. Sunil A Sheth23,
  23. Ansaar T Rai24,
  24. Thabele Leslie-Mazwi25,
  25. Joshua A Hirsch26
  1. 1 Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA
  2. 2 Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  3. 3 Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA
  4. 4 Interventional Neuroradiology and Neuroendovascularl Surgery, Miami Cardiac & Vascular Institute and Baptist Neuroscience Center, Miami, Florida, USA
  5. 5 Neurosurgery, University of South Florida, Tampa, Florida, USA
  6. 6 Radiology, Wake Forest University, Winston-Salem, North Carolina, USA
  7. 7 Neurosurgery, Wake Forest University, Winston-Salem, North Carolina, USA
  8. 8 Neurological Surgery, Winston Salem, North Carolina, USA
  9. 9 Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
  10. 10 Lehigh Valley Health Network, Allentown, Pennsylvania, USA
  11. 11 Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  12. 12 Radiology, Ochsner Medical System, New Orleans, Louisiana, USA
  13. 13 Department of Neurological Surgery, Rush University Medical Center, Chicago, Illinois, USA
  14. 14 Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
  15. 15 Radiology, University of Kansas Medical Center, Kansas City, Kansas, USA
  16. 16 Neurological Surgery, University of Kentucky, Lexington, Kentucky, USA
  17. 17 Department of Neurosurgery & Neuroradiology, University of Miami & Jackson Memorial Hospital, Miami, Florida, USA
  18. 18 Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  19. 19 Neurosurgery, University of Southern California, Los Angeles, California, USA
  20. 20 Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee, USA
  21. 21 Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
  22. 22 Neuroradiology, UT Southwestern, Dallas, Texas, USA
  23. 23 Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA
  24. 24 Interventional Neuroradiology, West Virginia University Hospital, Morgantown, West Virginia, USA
  25. 25 Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
  26. 26 NeuroEndovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Kyle M Fargen, Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, USA; kfargen{at}wakehealth.edu

Abstract

Background Burnout takes a heavy toll on healthcare providers. We sought to assess the prevalence and risk factors for burnout among neurointerventional (NI) non-physician procedural staff (nurses and technologists) given increasing thrombectomy demands.

Methods A 41-question online survey containing questions including the Maslach Burnout Inventory-Human Services Survey for Medical Personnel was distributed to NI nurses and radiology technologists at 20 US endovascular capable stroke centers.

Results 244 responses were received (64% response rate). Median (IQR) composite scores for emotional exhaustion were 25 (15–35), depersonalization 6 (2–11), and personal accomplishment 39 (35–43). Fifty-one percent of respondents met established criteria for burnout. There was no significant relationship between hospital thrombectomy volume, call frequency, call cases covered, or length of commute. On multiple logistic regression analysis, feeling under-appreciated by hospital leadership (OR 4.1; P<0.001) and working with difficult/unpleasant physicians (OR 1.2; P=0.05) were strongly associated with burnout. At participating centers, nurse and technologist attrition was 25% over the previous year. Over 50% of respondents indicated they had strongly considered leaving their position over the last 2 years.

Conclusions This survey of US NI non-physician procedural staff demonstrates a self-reported burnout prevalence of 51%. This was driven more by interaction with leadership and physician staff than by thrombectomy procedural volume and stroke call. Attrition among NI non-physician procedural staff is high.

  • thrombectomy
  • stroke
  • economics

https://doi.org/10.1136/neurintsurg-2020-015825

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    Footnotes

    • Twitter @rdeleacymd, @docroc99, @ashupjadhav, @AdamArthurMD, @leepride, @Ansaar_Rai, @JoshuaAHirsch

    • Contributors Concept design: KF. Survey creation: KF, JAH, SAA, AS, MM, GD. Data collection: all authors. Manuscript composition: KF, SAA, JAH, TL, SQW, PB. Final approval for article: all authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval IRB obtained through Wake Forest University, IRB00060849.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.