Background
Burnout (encompassing emotional exhaustion, depersonalization and personal accomplishment) in healthcare professionals is a major issue worldwide. Emergency medicine physicians are particularly affected, potentially impacting on quality of care and attrition from the specialty.
Objective
The aim of this study was to apply an attention-based training (ABT) program to reduce burnout among emergency multidisciplinary team (MDT) members from a large urban hospital.
Design, setting, participants and interventions
Emergency MDT members were randomized to either a no-treatment control or an intervention group. Intervention group participants engaged in a four session (4?h/session) ABT program over 7?weeks with a practice target of 20?min twice-daily. Practice adherence was measured using a smart phone application together with a wearable Charge 2 device.
Main outcome measures
The primary outcome was a change in burnout, comprising emotional exhaustion, depersonalization and personal achievement. The secondary outcomes were changes in other psychological and biometric parameters.
Results
The ABT program resulted in a significant reduction (P?<?0.05; T1 [one week before intervention] vs T3 [follow-up at two months after intervention]) in burnout, specifically, emotional exhaustion, with an effect size (probability of superiority) of 59%. Similar reductions were observed for stress (P?<?0.05) and anxiety (P?<?0.05). Furthermore, ABT group participants demonstrated significant improvements in heart rate variability, resting heart rate, sleep as well as an increase in pro-inflammatory cytokine expression.
Conclusion
This study describes a positive impact of ABT on emergency department staff burnout compared to a no-treatment control group.
Trial registration
ClinicalTrials.gov identifier NCT02887300.

Key words: Burnout, Emotional exhaustion, Meditation, Healthcare professional, Sleep, Stress, Cytokines, Cortisol, Randomized controlled trial