Categorizing objective-subjective hospital strain and clinician burnout patterns during respiratory viral surge periods to inform hospital resiliency and preparedness (OS Strain)

Surges in respiratory viruses, including both seasonal flus and rarer epidemics and pandemics (e.g. 2024 bird flu and COVID-19), put strain on hospitals and healthcare systems. The influx of infected patients during surges limits their capacity to provide high-quality care to all patients. Our team has pioneered an objective measurement of this capacity strain. But, during the COVID-19 pandemic, we also uncovered that hospital staff and leaders experience strain persisting beyond the period of measured objective strain. This experience of subjective strain suggested unmeasured organizational disruptions and/or that clinicians experience sustained burnout that compromises their abilities to provide effective care. Understanding how common and substantive the gaps are between objective and subjective strain, and why they occur, is essential to optimizing hospital adaptation (developing new processes to improve care), resiliency (continued high-quality care despite a surge), and preparedness for future surges.

The goals of this study are therefore to (1) rigorously define the relationship between clinician-perceived subjective strain and quantitatively measured objective hospital strain during and between respiratory viral seasons, (2) test whether clinician burnout is associated with this relationship, and (3) identify modifiable organizational and clinician characteristics that increase or protect against subjective strain and burnout.

We hypothesize that subjective and objective strain diverge in both degree and timing during respiratory viral seasons, that clinician burnout during and following surge periods mediates this divergence, and that there are identifiable organizational characteristics that can be targeted to mitigate strain. This work will identify actionable targets for organizational and training interventions to improve hospital resiliency and preparedness for respiratory viral surges, thus benefiting all patients admitted during these vulnerable periods.

National Heart, Lung, and Blood Institute