Factors Associated With a Positive View of Respiratory Care Leadership

Abstract

Background: Burnout within healthcare is prevalent and its effects are detrimental to patient outcomes, organizations, and individuals. These include increased prevalence of anxiety, depression, excessive alcohol and drug use, cardiovascular problems, and time off work. Prior data has suggested up to 50% of healthcare workers and up to 72% of respiratory therapists (RTs) experience burnout. Leadership has been cited as a key driver of burnout among RTs. We aimed to identify factors associated with a positive or negative leadership perception.

Methods: A post-hoc analysis of an IRB-approved survey to evaluate RT burnout, administered via REDCap by convenience sample to 26 respiratory care departments in healthcare centers from January 17– March 15, 2021, was performed to identify factors associated with a positive view of leadership. Survey questions included validated tools to measure leadership, burnout, staffing, COVID-19 exposure, and demographics. Data analysis was descriptive and logistic regression was performed to evaluate factors associated with leadership perception.

Results: Of the 1,080 responses, 710 (66%) had a positive view of leadership. Univariate analysis revealed those with a positive view of leadership were less likely to be working without adequate staffing, rarely unable to complete all work, less likely to be burned out, disagree that people in this work environment were burned out, less likely to miss work for any reason, less likely to care for adult patients, more likely to be in a leadership position, working fewer hours in intensive care, working in a center affiliated with a medical school, working day shift, and more likely to be male. Logistic regression revealed providing care to COVID-19 patients (OR 5.8 to 10.5, P < 0.001 to 0.006) was the only factor associated with a positive view of leadership while working without adequate staffing (OR 0.27 to 0.28, P = 0.002 to 0.006), staff therapist (OR 0.33, P < 0.001), work environments (OR 0.42, P = 0.003), missing work for any reason (OR 0.69, P = 0.003), and burnout score (OR 0.98, P < 0.001) were associated with a negative view of leadership.

Conclusions: Most RTs had a positive view of their leadership. A negative leadership score was associated with higher burnout and missing work. This relationship requires further investigation to evaluate if changes in leadership practices can improve employee well-being and reduce burnout.

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Figure 1 shows the responses to survey questions related to leadership positions and burnout.