Abstract
STUDY OBJECTIVES: Management research suggests that effective communication by leaders is associated with reduced burnout and improved coordination. However, characteristics of communication that make it more useful to those who receive it are not well understood. The study objective was to examine associations between how emergency department (ED) staff experienced information communicated by leaders during the COVID-19 pandemic and their experience of burnout and teamwork. METHODS: A cross-sectional survey was administered to 635 ED staff (N = 191, response rate = 30%) working in 2 EDs affiliated with an academic emergency medicine program in California between October-December 2021. Burnout (“based on your definition of burnout, how would you rate your level of burnout?”) was measured on a 5-point Likert scale. Teamwork experience was measured as the mean of 2 modified items from a validated scale asking, “during a clinical shift, when problems arose due to COVID, we addressed them as a team effort in the ED” and “we have been able to rely on all roles to jointly solve problems due to COVID in this ED.” Informed by qualitative interviews reported in a previous study and measures from previously developed instruments, questions regarding the characteristics of information communication by leaders were developed. Exploratory factor analysis (EFA) was conducted using principle axis factoring with oblique rotation. Factor extraction criteria included eigen values exceeding the threshold of 1. Items were assigned to factors if they had loadings >0.4. These factors were assessed in relation to experienced burnout and teamwork using linear regression models (Table 1). Models controlled for age, sex, race, role, and primary shift worked. RESULTS: EFA results suggested a 3-factor solution. Factors consisted of items related to information flow (ie “information is shared too frequently”), content consistency (ie “information changes based on where I receive it from”), and accessibility (ie “information is easily accessible such that I can find what I’m looking for easily”). Regression models revealed a negative and statistically significant relationship between information accessibility and burnout (B=-0.28, p<0.01). This association remained statistically significant when controlling for the flow and content factors. Models revealed that all three factors were positively and statistically significantly associated with teamwork experience; however, this association only remained statistically significant for information accessibility (B=-0.40, p<0.01) when controlling for the other 2 factors. CONCLUSION: Amid the heightened experience of burnout among health care workers during COVID-19, attention to the experience of frontline staff and their nuanced needs for information is vital. Leaders seeking to effectively communicate with staff amid uncertainty should be mindful of how staff experience information flow, content consistency, and especially, accessibility. Although leaders are often advised that there is no such thing as overcommunication, overwhelming information flow can be harmful if communication is irrelevant to fatigued staff. When disseminating information, leaders should check that communication is consistent across channels; otherwise, staff may feel that the content shared is inaccurate. Lastly, leaders should ensure that communicated information is easy to access, understand, and interpret.
