Abstract WP114: Texas Stroke Program Assessment: Infrastructure, Turnover, and Burnout Implications

Abstract

Introduction: Unlike state designation for trauma centers, there are no Texas State rules on certain infrastructure requirements for stroke designation and independent stroke center accreditation. To assess the current state of program manager impact, a Texas Stroke Program Survey was administered. Hypothesis: Lack of requirements results in overburdened programs, high turnover, poor mentorship, and burnout. Methods: Electronic survey contained program assessment with link to validated instrument (MBI-HSS), administered by Mind Garden Inc, to assess burnout, well-being, and work-related dimensions for medical personnel. Of the 181 Texas designated stroke facilities, 98% were contacted with each site having one anonymous senior program staff member complete the survey. Results: Survey responses were 105 among which 78 completed MBI-HSS (26% CSC, 1% TCS, 59.6% PSC, 17.3% ASRH). Respondents: 66.7% stroke coordinators, 23.8% stroke program managers/directors, and 9.5% identified as other. Majority (41%) were in current role for 1-2 yrs (19% <1 yr, 20% 3-5 yrs, 13.3% 6-9 yrs, 6.7% > 10 yrs) and 42.9% did not consider resigning. Over 5 yr period, 49.5% reported 2 or more turnovers of their position (none 26.7%, once 21.9%, twice 20%, > twice 29.5%, new role 1.9%). Majority (57.1%) reported serving more than one major role at facility. Reported 67.3% had dedicated stroke coordinators and 49% data collectors. Only 53.3% reported adequate resources and 15.2% felt program was priority with sufficient hospital support. Role on-boarding was reported by 16.2% and 61.9% reported no mentorship. MBI-HSS revealed 74.4% had burnout profile of ineffective, overextended, or burnout. Conclusion: Survey demonstrates variability in infrastructure, reduced support and mentorship, high rates of turnover and burnout in Texas stroke programs. Nearly all respondents (91.4%) felt requirements for infrastructure and support for stroke program development and growth were needed.