{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:52:05Z","timestamp":1791305525373,"version":"4.3.1"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>Staff in neurocritical care units (NCCUs) are particularly vulnerable to burnout, negatively affecting team dynamics and education. We evaluated the impact of several stakeholder-led, resilience-building interventions on staff burnout and team dynamics in the NCCU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN:<\/jats:title>\n                    <jats:p>Participatory, stakeholder-led, quality improvement intervention-based project with serial cross-sectional surveys.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING:<\/jats:title>\n                    <jats:p>NCCUs at the Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, within the Johns Hopkins Medicine NCCU Division.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects:<\/jats:title>\n                    <jats:p>Multidisciplinary NCCU members, including fellows, attending physicians, advanced practice providers (APPs), pharmacists, nurses, and ancillary staff, were eligible. Participation was voluntary and anonymous.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>INTERVENTIONS:<\/jats:title>\n                    <jats:p>Between October 2023 and September 2024, a multidisciplinary working group identified key drivers of burnout and impaired team dynamics and implemented interventions targeting individual and organizational resilience. Strategies included a shared vision statement, a zero-tolerance pledge for unprofessional behavior, enhanced leadership communication, recognition mechanisms, team-building professional development sessions, social events, workflow revisions, and restructuring of educational programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS AND MAIN RESULTS:<\/jats:title>\n                    <jats:p>\n                      Surveys were conducted at baseline, 6 months, 1 year, and 2 years, using the Maslach Burnout Inventory and Team Dynamics Surveys. The average response rate was 68% (53% nurses, 20% faculty, 9% fellows, and 18% APPs\/pharmacists\/ancillary staff). Over 2 years, the median (interquartile range) total emotional exhaustion score improved from 25 (19\u201330) to 9 (9\u201318), depersonalization score from 9 (7\u201313) to 5 (5\u201310), and the personal accomplishment score from 29 (26\u201332) to 40 (32\u201340; all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Sustained improvement was also noted in all domains of the Team Dynamics Survey (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). During this timeframe, the mean fellow in-service examination score also increased between April 2024 (pre-intervention) and April 2025 (+14%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), 1-year post-intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>A participatory, stakeholder-driven quality improvement initiative with multipronged interventions targeting resilience and team dynamics reduced burnout, improved team well-being, and was temporally associated with improved trainee educational performance in high-acuity NCCUs. This framework is feasible, sustainable, and adaptable to other ICU environments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ccm.0000000000007281","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:40:47Z","timestamp":1786545647000},"page":"2697-2708","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Fostering Resilience: The Role of Team Dynamics in Mitigating Burnout and Enhancing Well-Being in the Neurocritical Care Unit"],"prefix":"10.1097","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9657-6383","authenticated-orcid":false,"given":"Vishank A.","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junaid","family":"Ansari","sequence":"additional","affiliation":[{"name":"Department of Neurology, Louisiana State University Health Shreveport, Shreveport, LA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Quinlan","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karissa L.","family":"Dushel","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care and Neurosciences Nursing, The Johns Hopkins Hospital, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Zink","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care and Neurosciences Nursing, The Johns Hopkins Hospital, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salia","family":"Farrokh","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Department of Pharmacy, Johns Hopkins Hospital, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hering","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care and Neurosciences Nursing, The Johns Hopkins Hospital, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Trautman","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care and Neurosciences Nursing, The Johns Hopkins Hospital, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Bartock","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care and Neuroscience Nursing, The Johns Hopkins Bayview Medical Center, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austen","family":"Lefebvre","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Min","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Muehlschlegel","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Bienstock","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose I.","family":"Suarez","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."},{"name":"Division of Neurosciences Critical Care, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"R1-20261006","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1007\/s12028-023-01750-0","article-title":"A survey of burnout among neurocritical care practitioners.","volume":"40","author":"Aboutaleb","year":"2024","journal-title":"Neurocrit 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