13. EVALUATING THE RELATIONSHIP BETWEEN TEAMWORK, ORGANIZATION, CULTURE AND BURNOUT AMONG RESIDENTS

Rationale Little research has explored in depth the relationship between organizational, individual, and program factors contributing to burnout, and the resident perspective on how best to address burnout. Objective The Maslach Burnout Inventory (MBI) was administered to residents and focus groups were conducted to explore how organizational, individual and program factors affect burnout in a medium sized, urban, academic pediatric residency program. Methods A constant comparison analysis was used to derive themes from focus groups until achieving thematic saturation. Residents completed the MBI following a department wide saturation in training model of the Strategies and Tools to Enhance Performance and Patient Safety program. Burnout was defined as a high subscale score for the burnout domain (>27) and/or the depersonalization domain (>10) on the MBI. Results 3 focus groups of 10 total residents were conducted and 31 residents completed the MBI. 4 themes were identified from the focus groups. First, at a program level, offering an individualized approach to wellness is important. Second, ensuring residents feel appreciated prevents feelings of lack of personal achievement. Third, from an organization perspective, teamwork training boosts interdepartmental relationships, but may not provide adequate reinforcement and should be supported by frequent debriefings to promote positive team culture. Lastly, getting residents back to the bedside and reducing documentation burden is key. Quantitative data supported qualitative findings, with 61% of residents meeting criteria for burnout. Conclusions A multifactorial approach to addressing burnout in pediatric residents requires the development of organizational infrastructure and program level interventions to support residents. It is essential to create a culture that ensures residents can prioritize clinical education, develops effective communication and reflective skills through team training and debriefing, and gets residents back to the bedside. Program interventions should give residents autonomy around wellness and educational activities.