Critical Care Workforce Research Articles

The Impact of Dobbs v Jackson on Future Critical Care Workforce A Cross-Sectional Survey

The Impact of Dobbs v Jackson on Future Critical Care Workforce A Cross-Sectional Survey

Critical care pharmacy service provision and workforce in adult extracorporeal membrane oxygenation centres: a multicentre cross-sectional survey.

There is good evidence describing pharmacy workforce and service provision in general critical care units. However, no data exist from adult extracorporeal membrane oxygenation (ECMO) centres. To describe workforce characteristics, pharmacy service provision, and pharmaceutical care activities in critical care units (CCUs) providing an adult ECMO service in the United Kingdom (UK) and compare to national staffing standards for CCUs. We conducted a multicentre, cross-sectional electronic survey inviting one pharmacy professional response per UK ECMO centre. We collated information on workforce, service provision, and pharmaceutical care activities provided by pharmacy teams in adult CCUs with an ECMO service. The survey response rate was 90.9%: representatives of 10/11 tertiary hospitals providing ECMO services responded. Median critical care pharmacist to critical care bed was 1:12.1 (IQR: 1:9.4-1:14.9). Most centres (90.0%) did not meet national standards for pharmacy professionals to critical care bed staffing ratios for weekday services. Total critical care beds covered by the critical care pharmacy team varied across the UK: median (IQR) - 45 (37-80) beds. Two centres funded pharmacist time for ECMO activity, and one centre funded a pharmacy technician post. Median peak ECMO activity was 4 ECMO patients in a single day (IQR: 3-5). Most respondents reported reduced pharmacy service at weekends compared to weekday, with limited on-site support. Most responding ECMO centres in the UK reported pharmacy staffing ratios below nationally agreed critical care standards. There was high variability in clinical pharmacy services to ECMO patients over 7days.

Ventilator Training through International Telesimulation in Sierra Leone.

The coronavirus disease (COVID-19) pandemic resulted in an increased need for medical professionals with expertise in managing patients with acute hypoxemic respiratory failure, overwhelming the existing critical care workforce in many low-resource countries. To address this need in Sierra Leone, we developed, piloted, and evaluated a synchronous simulation-based tele-education workshop for healthcare providers on the fundamental principles of intensive care unit (ICU) management of the COVID-19 patient in a low-resource setting. Thirteen 2-day virtual workshops were implemented between April and July 2020 with frontline Sierra Leone physicians and nurses for potential ICU patients in hospitals throughout Sierra Leone. Although all training sessions took place at the 34 Military Hospital (a national COVID-19 center) in Freetown, participants were drawn from hospitals in each of the provinces of Sierra Leone. The workshops included synchronous tele-education-directed medical simulation didactic sessions about COVID-19, hypoxemia management, and hands-on simulation training about mechanical ventilation. Measures included pre and postworkshop knowledge tests, simulation checklists, and a posttest survey. Test results were analyzed with a paired sample t test; Likert-scale survey responses were reported using descriptive statistics; and open-ended responses were analyzed using thematic analysis. Seventy-five participants enrolled in the program. On average, participants showed 20.8% improvement (a score difference of 4.00 out of a maximum total score of 20) in scores between pre and postworkshop knowledge tests (P = 0.004). Participants reported satisfaction with training (96%; n = 73), achieved 100% of simulation checklist objectives, and increased confidence with ventilator skills (96%; n = 73). Themes from the participants' feedback included increased readiness to train colleagues on critical care ventilators at their hospitals, the need for longer and more frequent training, and a need to have access to critical care ventilators at their hospitals. This synchronous tele-education-directed medical simulation workshop implemented through partnerships between U.S. physicians and Sierra Leone healthcare providers was a feasible, acceptable, and effective means of providing training about COVID-19, hypoxemia management, and mechanical ventilation. Future ICU ventilator training opportunities may consider increasing the length of training beyond 2 days to allow more time for the hands-on simulation scenarios using the ICU ventilator and assessing knowledge application in long-term follow-up.

Perceptions of gender equity among critical care and other health professionals: A cross-sectional survey

ObjectiveThe objective of this study was to determine the association between gender and perceived gender equity in the critical care workforce and other health specialties. Design and settingWe conducted an online cross-sectional survey between September and November 2020. Data on demographics and perceptions of equity including the representation of women across departments and in leadership roles, knowledge of and access to flexible work practices and carers leave, and opportunities for promotion were collected. ParticipantsThe study population included health professionals from critical care (defined as intensive care and emergency) and other specialties. We conducted a descriptive gender-disaggregated analysis. ResultsA total of 478 respondents (70% women) completed the survey. The mean age of respondents was 43.9 ± 11.2 years. Approximately half of respondents were medical practitioners (n = 235, 54%), followed by nurses (n = 135, 36%)—the remainder were from other professions. The critical care workforce accounted for 280 (64%) of responder practice settings. Statistically significant differences were reported between genders on issues such as having confidence that their department would resolve equity issues (87 [70.7%] men vs. 146 [48.2%] women; p = 0.007), access to flexible work practices (5/124 [4.0%] men vs. 20/305 [6.6%] women p = 0.001), and taking unpaid leave for carer responsibilities (91 [30.3%] women vs 9 [7.4%] men, p < 0.001). ConclusionsThis work highlights differences in how men and women perceive gender equity, particularly in the critical care workforce. These findings are important to understand health care practitioners’ perceptions of gender equity, as these perceptions inform behaviour.

A New Model for Postgraduate and Continuing Education in Disaster and Terror Medicine

Introduction:Postgraduate education is important in preparing and enhancing health professionals for the practice of disaster and terror medicine. The World Association for Disaster and Emergency Medicine (WADEM) has formulated a standardized international perspective for education and training in disaster medicine and health. Notwithstanding, there continues to be a reported gap in competency-based training in disaster and terror medicine internationally, particularly across Asia Pacific, which is a known vulnerable region. We report on a new Graduate Diploma in Disaster and Terror Medicine, to be expanded to Master level in 2024. The course is delivered mainly online to a multidisciplinary international audience. This paper summarizes the development of the course and outlines the key influences that have contributed to the design of the course.Method:A survey of the critical care workforce conducted by the Department of Critical Care at the University of Melbourne in early 2020 identified the need to develop education in disaster and terror medicine. A market and competitor analysis identified there was a gap in clinician focused courses offered in Australia and internationally. Based upon these results, a new course was developed to meet these needs.Results:Based on the results of the survey and feedback from expert stakeholders, the new postgraduate courses in disaster and terror medicine were developed. They offer both core and elective subjects, utilizing a modular approach with supervised simulation and practical training. The courses incorporate problem-based learning, the principles and practices of online education and advances in simulation-based learning, providing both a public health and clinical lens.Conclusion:The nested suite of postgraduate disaster and terror medicine courses at the University of Melbourne is at the forefront of learning within this field and meets the contemporary needs of health professionals who practice disaster and terror medicine

Is this the solution to wellbeing and burnout management for the critical care workforce? A parallel, interventional, feasibility and realist informed pilot randomized control trial protocol.

Critical care healthcare professionals are at high risk in developing burnout and mental health disorders including depression, anxiety, and post-traumatic stress disorder. High demands and the lack of resources lead to decreased job performance and organizational commitment, low work engagement, and increases emotional exhaustion and feelings of loneliness. Peer support and problem-solving approaches demonstrate promising evidence as it targets workplace loneliness, emotional exhaustion, promotes work engagement, and supports adaptive coping behaviors. Tailoring of interventions have also shown to be effective in influencing attitudes and behavior changes, attending to the individual experience and specific needs of end-users. The purpose of this study is to assess the feasibility and user-perceived acceptability of a combined intervention (Individualized Management Plan (IMP) and Professional Problem-Solving Peer (PPSP) debrief) in critical care healthcare professionals. This protocol was registered in the Australian and New Zealand Clinical Trials Registry (ACTRN12622000749707p). A two-arm randomized controlled trial, with pre-post-follow-up repeated measures intergroup design with 1:1 allocation ratio to either 1) treatment group-IMP and PPSP debrief, or 2) active control group-informal peer debrief. The primary outcomes will be conducted by assessing the recruitment process enrolment, intervention delivery, data collection, completion of assessment measures, user engagement and satisfaction. The secondary outcomes will explore preliminary effectiveness of the intervention using self-reported questionnaire instruments from baseline to 3-months. This study will provide the interventions' feasibility and acceptability data for critical care healthcare professionals and will be used to inform a future, large-scale trial testing efficacy.

Need Analysis of Indian Critical Health Care Delivery in Government Sectors and Its Impact on the General Public: A Time to Revamp Public Health Care Infrastructure.

Poverty is directly linked to public health care delivery in many ways and dimensions. Every aspect of the human sphere is preplanned, but a health crisis is the only emergency which pushes humanity into severe economic stress. Therefore, every nation aims to safeguard its citizens from a health crisis. In this aspect, India needs to improve its public health infrastructure in order to protect its citizens and save them from poverty. (1) To assess the current pitfalls in public critical health care delivery, (2) to analyze whether the health care delivery matches the requirements of its population in every state, (3) to produce solutions and guidelines to overcome the stress in this priority area. Data regarding the critical care workforce, which includes critical care doctors and nurses, were taken from official websites and other sources. Critical care infrastructure data were retrieved from the Internet sources. Data were validated by consulting state government sources and cross-checked for bias elimination. The data were analyzed using the "Statistical Package for Social Sciences" software version 20, and were presented using descriptive statistics. There is a 1:10 percentage of deficit in the case of critical care workforce and infrastructure when compared with its need analysis. Critical care medicine specialists are in 1:75 when compared to other specialties. Overall, the public sector critical care needs a total boost through out of box solutions. According to the Stockholm International Peace Research Institute (SIPRI), India spent the third most on defense in the world in 2021. India spent 76.6 billion dollars on its military in 2021, up 33% from 2012 and 0.9% from 2020. However, since India is considered a fast-growing economy, there is still a huge disparity in critical care. Without resetting critical health care, India cannot grow in welfare indices even if it is among the top gross domestic product (GDP) countries. Prabu D, Gousalya V, Rajmohan M, Dinesh MD, Bharathwaj VV, Sindhu R, et al. Need Analysis of Indian Critical Health Care Delivery in Government Sectors and its Impact on the General Public: A Time to Revamp Public Health Care Infrastructure. Indian J Crit Care Med 2023;27(4):237-245.

Satisfaction, Stress, and Turnover: Comparing U.S. Intensivist Physicians Before and During the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic.

A cross-sectional electronic survey. Critical care practices in the United States. U.S. physician members of the Society for Critical Care Medicine. A total of 1,148 intensivists completed online surveys administered in two waves: in 2016 (693 respondents) and in the late 2021 to early 2022 (455 respondents). They reported demographic and practice characteristics, self-perceived levels of satisfaction, stress, health, and intention to leave their current job. U.S.-based critical care physicians in 2022 report significantly lower levels of job satisfaction compared with 2016. Frequency of work stress and turnover intention also increased, whereas WLB satisfaction has remained the same. Nearly two-thirds of intensivists wish they could work fewer hours, and this discontentment is correlated with decreased satisfaction, increased stress, and increased turnover, particularly in pandemic respondents. More than 25% of physicians rated their mental health as poor or fair, and 20% rated their physical health as poor or fair; these self-ratings correlated with decreased satisfaction and increased stress and turnover intention. The SARS-CoV-2 pandemic has further burdened an already-strained critical care workforce. During the pandemic, job satisfaction fell, work stress became more frequent, and turnover intention increased for critical care physicians. They also have consistently low rates of WLB satisfaction. Work hours matter the most for physician satisfaction, stress, and turnover intention, and the desire to work fewer hours is negatively related to all outcomes. Many critical care physicians reported poor mental and physical health during the pandemic, which is strongly and negatively related to all outcomes. These results emphasize the importance of prioritizing the working preferences and the self-care of intensivist physicians.

The Post Coronavirus Disease-19 Pandora-Box: Future Directions for Critical Care in Low and Medium-Income Countries

The novel Coronavirus disease-19, caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 virus posed a worldwide public health emergency and remains a large health burden till date in some continents, causing a significant morbidity and mortality among the critically-ill, not sparing the low and medium-income countries. The critical care surge in most countries exposed the unpreparedness and “struggling” health systems of these countries, including Low and medium-income countries in containing the epidemic. The suddenness of Coronavirus disease in China is suggestive that another “Pathogen X” epidemic may occur. In addition, the increasing global terrorism index may precipitate another epidemic secondary to a bioterrorism contagion. In mitigating this, however, lessons learnt from the management of the critically-ill patients with the Coronavirus disease may assist the low and medium-income countries in charting the future directions of critical care in the event of any Post Coronavirus disease public health challenge. The import of systems approach and collaboration with development partners cannot be over-emphasized, alongside increasing critical care beds and improving oxygen availability and accessibility. Finally, changing the narrative of “struggling” health systems of developing countries by addressing the major debilitating factors, including the issue of critical care workforce and training is needed. The new Essential and Emergency Critical Care training program is proffered. Furthermore, offering skilled healthcare workers adequate remuneration and other incentives to guard against their migration to “greener pastures” may help the low and middle-income countries retain critical care specialists in preparing for any sudden Post-Coronavirus disease public health emergency.

108: INFLUENCE OF COVID-19 ON BURNOUT AMONG CRITICAL CARE ADVANCED PRACTICE PROVIDERS

Introduction: Burnout results from physical and mental exhaustion and affects the intentionality to leave the profession. Unfortunately, burnout scenarios have been quite common among Critical Care Advance Practice Providers (APPs). The calls to action to sustain the critical care workforce were in full force before COVID-19 attacked the world and rapidly turned into a pandemic. Already overburdened and depleted critical care workforce was further exacerbated by overwhelming work demands. Our research was aimed at understanding the influence of COVID-19 on the critical care APPs. Methods: We utilized a cross-sectional REDCap survey to understand the self-perceived extent to which the burnout among critical APPs had changed. A single link to survey was emailed to 2775 SCCM physician assistant and nursing section members. There were 578 responses (response rate 20.8%). After excluding 60 non-APPs responses, our sample size was 518. Survey questions asked about the symptoms of emotional exhaustion, depersonalization, perception of reduced personal accomplishments and intention to leave. Results: We found an increase in burnout and related dimensions. Emotional exhaustion increased from 28.8%-69.9%, depersonalization increased from 17.2%-37.6%%, and perception of reduced personal accomplishments increased from 18.1%-38% among our study population. We also asked about the intentions to leave critical care and a total of 513 participants engaged with this question. Twenty-two percent (n=114) of our sample expressed an intention to leave critical care. We also asked about the intention to leave the profession altogether and only 21.8% (n=113) participants responded. A total of 43.3% (n=49) respondents reported the intention to leave the profession altogether within the following 2-5 years. Of those who responded, 22.1% (n=25) intended to leave within 1 year and 25.7% (n=29) intended to leave between 5-10 years while 8.9% (n=10) stated that they intended to stay beyond 10 years. Conclusions: COVID-19 pandemic exacerbated the burnout and its dimensions among critical care APPs. It is crucial to attend to the trends in burnout and intention to leave and mitigation strategies must be employed to sustain the critical care workforce which is key to planning the future of critical care in the US and globally.

Why women say no to leadership positions.

Despite a growing trend of more women entering pediatric critical care training programs, women continue to be underrepresented in leadership positions. A 2019 report on the pediatric critical care workforce revealed that only 32% of division directors are women and 25% of Department of Pediatrics Chairs are women. Women in critical care face systemic barriers to advancement into leadership positions which often lead women to reject leadership positions despite being appropriately matched or even overqualified for the position. The obstacles can appear insurmountable, especially for women of color and mothers of young children. In this article, I share my perspective on strategies to reduce these hurdles by providing guidance on preparing for these roles, embracing and promoting women when opportunities arises and matching recruitment packages to women’s values. If the goal is to recruit and retain more women into the ranks of academic leadership, especially women of color, academia must transform current practices. An approach that aims to fully understand the leader’s motivation is a key first step. Additionally, we need to invest in women earlier in their career, reward often uncompensated work, value women at their home institution, offer salary transparency and recognize the unique challenges of leading while mothering.

Missed nursing care in the critical care unit, before and during the COVID-19 pandemic: A comparative cross-sectional study

ObjectivesTodescribe and evaluate reported missed nursing care in the critical care context during different phases of the COVID-19 pandemic in Sweden. Research methodologyA comparative cross-sectional design was used, comparing missed nursing care in three samples: before the COVID-19 pandemic in 2019, during the second wave of the pandemic in spring 2020, and during the third wave of the pandemic in fall 2021. SettingThe study was conducted at critical care units at a university hospital, Sweden. Main outcome measuresThe MISSCARE Survey-Swedish version was used to collect data along with two study-specific questions concerning perception of patient safety and quality of care. ResultsSignificantly more overtime hours and number of days absent due to illness were reported during the pandemic. The nurse/patient ratio was above the recommended level at all data collection time points. Most missed nursing care was reported in items concerning basic care. The most reported reasons for missed nursing care in all samples concerned inadequate staffing, urgent situations, and a rise in patient volume. Most nurses in all samples perceived the level of patient safety and quality of care as good, and the majority had no intention to leave their current position. ConclusionThe pandemic had a great impact on the critical care workforce but few elements of missed nursing care were affected. To measure and use missed nursing care as a quality indicator could be valuable for nursing managers, to inform them and improve their ability to meet changes in patient needs with different workforce approaches in critical care settings.

The Influence of the COVID-19 Pandemic on Intensivists’ Well-Being: A Qualitative Study

BackgroundThe COVID-19 pandemic has strained health care systems and has resulted in widespread critical care staffing shortages, negatively impacting the quality of care delivered.Research QuestionHow have hospitals’ emergency responses to the pandemic influenced the well-being of frontline intensivists, and do any potential strategies exist to improve their well-being and to help preserve the critical care workforce?Study Design and MethodsWe conducted semistructured interviews of intensivists at clusters of tertiary and community hospitals located in six regions across the United States between August and November 2020 using the “four S” framework of acute surge planning (ie, space, staff, stuff, and system) to organize the interview guide. We then used inductive thematic analysis to identify themes describing the influence of hospitals’ emergency responses on intensivists’ well-being.ResultsThirty-three intensivists from seven tertiary and six community hospitals participated. Intensivists reported experiencing substantial moral distress, particularly because of restricted visitor policies and their perceived negative impacts on patients, families, and staff. Intensivists also frequently reported burnout symptoms as a result of their experiences with patient death, exhaustion over the pandemic’s duration, and perceived lack of support from colleagues and hospitals. We identified several potentially modifiable factors perceived to improve morale, including the proactive provision of mental health resources, establishment of formal backup schedules for physicians, and clear actions demonstrating that clinicians are valued by their institutions.InterpretationRestrictive visitation policies contributed to moral distress as reported by intensivists, highlighting the need to reconsider the risks and benefits of these policies. We also identified several interventions as perceived by intensivists that may help to mitigate moral distress and to improve burnout as part of efforts to preserve the critical care workforce.

Workforce demographics and unit structure in paediatric cardiac critical care in the United States.

To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States. REDCap surveys were sent by email from May till August 2019 to medical directors ("directors") of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure. Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%). Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

The Mount Sinai Hospital Institute for critical care medicine response to the COVID-19 pandemic.

Background The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of critically ill patients. This was especially true in New York City. We present a roadmap for hospitals and healthcare systems to prepare for a Pandemic.Methods This was a retrospective review of how Mount Sinai Hospital (MSH) was able to rapidly prepare to handle the pandemic. MSH, the largest academic hospital within the Mount Sinai Health System, rapidly expanded the intensive care unit (ICU) bed capacity, including creating new ICU beds, expanded the workforce, and created guidelines.Results MSH a 1,139-bed quaternary care academic referral hospital with 104 ICU beds expanded to 1,453 beds (27.5% increase) with 235 ICU beds (126% increase) during the pandemic peak in the first week of April 2020. From March to June 2020, with follow-up through October 2020, MSH admitted 2,591 COVID-19-positive patients, 614 to ICUs. Most admitted patients received noninvasive support including a non-rebreather mask, high flow nasal cannula, and noninvasive positive pressure ventilation. Among ICU patients, 68.4% (n=420) received mechanical ventilation; among the admitted ICU patients, 42.8% (n=263) died, and 47.8% (n=294) were discharged alive.Conclusions Flexible bed management initiatives; teamwork across multiple disciplines; and development and implementation of guidelines were critical accommodating the surge of critically ill patients. Non-ICU services and staff were deployed to augment the critical care work force and open new critical care units. This approach to rapidly expand bed availability and staffing across the system helped provide the best care for the patients and saved lives.

The impact of COVID-19 on anaesthesia and critical care services in the UK: a serial service evaluation.

SummaryBetween October 2020 and January 2021, we conducted three national surveys to track anaesthetic, surgical and critical care activity during the second COVID‐19 pandemic wave in the UK. We surveyed all NHS hospitals where surgery is undertaken. Response rates, by round, were 64%, 56% and 51%. Despite important regional variations, the surveys showed increasing systemic pressure on anaesthetic and peri‐operative services due to the need to support critical care pandemic demands. During Rounds 1 and 2, approximately one in eight anaesthetic staff were not available for anaesthetic work. Approximately one in five operating theatres were closed and activity fell in those that were open. Some mitigation was achieved by relocation of surgical activity to other locations. Approximately one‐quarter of all surgical activity was lost, with paediatric and non‐cancer surgery most impacted. During January 2021, the system was largely overwhelmed. Almost one‐third of anaesthesia staff were unavailable, 42% of operating theatres were closed, national surgical activity reduced to less than half, including reduced cancer and emergency surgery. Redeployed anaesthesia staff increased the critical care workforce by 125%. Three‐quarters of critical care units were so expanded that planned surgery could not be safely resumed. At all times, the greatest resource limitation was staff. Due to lower response rates from the most pressed regions and hospitals, these results may underestimate the true impact. These findings have important implications for understanding what has happened during the COVID‐19 pandemic, planning recovery and building a system that will better respond to future waves or new epidemics.

Covid-19 1 year on: The challenge for low-middle income countries.

Covid-19 1 year on: The challenge for low-middle income countries.

Intensive care digital health response to emerging infectious disease outbreaks such as COVID-19.

The COVID-19 pandemic has required intensive care units to rapidly adjust and adapt their existing practices. Although there has a focus on expanding critical care infrastructure, equipment and workforce, plans have not emphasised the need to increase digital capabilities. The objective of this report was to recognise key areas of digital health related to the COVID-19 response. We identified and explored six focus areas relevant to intensive care, including using digital solutions to increase critical care capacity, developing surge capacity within an electronic health record, maintenance and downtime planning, training considerations and the role of data analytics. This article forms the basis of a framework for the intensive care digital health response to COVID-19 and other emerging infectious disease outbreaks.

Diversity, Equity, and Inclusion: A strategic priority for the American Pediatric Surgical Association

Diversity, Equity, and Inclusion: A strategic priority for the American Pediatric Surgical Association

Abstract 16121: Wellness in Pediatric Cardiac Intensivists - How are We Doing?

Introduction: Poor physician wellness is associated with detrimental effects on patient outcomes. There are no data on physician wellness in pediatric cardiac critical care. We aimed to define the prevalence of and risk factors for impaired wellness using a targeted survey of the North American pediatric cardiac critical care workforce. Methods: We developed a survey to examine physician wellness and potential risk factors, incorporating the Expanded Physician Well Being Index. Unit directors at 120 congenital heart surgery centers were contacted to provide faculty emails. The survey was distributed to each faculty with targeted reminders from June - September 2019. Univariate and multivariable logistic regression analyses were performed comparing the at-risk respondents to those not at risk for poor wellness. Results: Of the 477 faculty, 294 completed the survey (62%). Faculty reported working a median of 83 hours on service weeks and 50 hours on non-service weeks. Based on Well-Being scores, 34% were in the “at risk” category; 56% reported feeling burned out in the past month and 46% reported feeling overwhelmed. However, 96% felt their work was meaningful. Faculty reported a high incidence of developing unhealthy habits including poor nutrition (50%), infrequent exercise (56%), and lack of self-care (46%). Factors associated with well-being risk are shown in Table 1. Poor interpersonal experiences, higher work hours, and being primarily trained in critical care with an additional cardiac year were associated with risk of poor wellness. Working &gt;100 hours per service week had a significant increase in risk (odds ratio 2.3, 95% confidence interval 1.31-4.40). Availability of wellness services was associated with reduced risk. Conclusion: Burnout and risk of poor wellness are common in pediatric cardiac critical care faculty. Modifiable factors, including wellness service availability and reduced hours of clinical service may improve wellness in the workforce.