Transition to a Semiclosed Surgical Intensive Care Unit (SICU) Leads to Improved Resident Job Satisfaction: A Prospective, Longitudinal Analysis

Tinti, Meredith S.; Haut, Elliott R.; Horan, Annamarie D.; Sonnad, Seema; Reilly, Patrick M.; Schwab, C. William; Gracias, Vicente H.

doi:10.1016/j.jsurg.2008.09.005

« Previous Next »Journal of Surgical Education
Volume 66, Issue 1 , Pages 25-30, January 2009

Transition to a Semiclosed Surgical Intensive Care Unit (SICU) Leads to Improved Resident Job Satisfaction: A Prospective, Longitudinal Analysis

Meredith S. Tinti, MD
- Division of Trauma and Critical Care, Department of Surgery, UMDNJ- Robert Wood Johnson University Hospital, New Brunswick, New Jersey
- Correspondence: Inquiries to Meredith Tinti, MD. UMDNJ-Robert Wood Johnson University Hospital, 1RWJ Place- PO, Box, and 19 MEB 4th Floor, New Brunswick, NJ 08816
Elliott R. Haut, MD
- Division of Trauma and Critical Care, Department of Surgery, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
Annamarie D. Horan, PhD
- Division of Traumatology and Surgical Critical Care, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, The Hospital of the University of Pennsylvania, The University of Pennsylvania School of Medicine, Philadelphia, PA
Seema Sonnad, PhD
- Department of Surgery, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, The Hospital of the University of Pennsylvania, The University of Pennsylvania School of Medicine, Philadelphia, PA
Patrick M. Reilly, MD
- Division of Traumatology and Surgical Critical Care, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, The Hospital of the University of Pennsylvania, The University of Pennsylvania School of Medicine, Philadelphia, PA
C. William Schwab, MD
- Division of Traumatology and Surgical Critical Care, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, The Hospital of the University of Pennsylvania, The University of Pennsylvania School of Medicine, Philadelphia, PA
Vicente H. Gracias, MD
- Division of Traumatology and Surgical Critical Care, The University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, The Hospital of the University of Pennsylvania, The University of Pennsylvania School of Medicine, Philadelphia, PA

Obejctive

Patients, family members and ICU nurses have a higher level of satisfaction with the semiclosed ICU model. Whether or not resident physicians have this same reaction has not yet been investigated. We hypothesized that surgical residents would have improved job satisfaction with the transition from a mandatory consultation SICU to a semiclosed SICU model.

Design

Prospective, longitudinal survey.

Setting

Tertiary-care University Hospital.

Participants

Categorical general surgery residents.

Interventions

Change from mandatory consultation SICU to semiclosed SICU.

Measurements and Main Results

Categorical surgery residents at a tertiary-care university hospital were surveyed at 3 time points during and after the transition from a mandatory consultation SICU to a semiclosed SICU. The survey consisted of 12 questions designed to gauge the residents' overall job satisfaction as related to the SICU. All questions were on a 5-point Likert scale. Analysis of variance for trend and Fisher exact test were performed to compare the responses.

97 surveys were received. The response rates for the 3 periods were 66, 62 and 72%. Residents were less likely to feel “out of the loop” regarding the care of their ICU patients in the later periods (p = 0.046). There was significant improvement over time in scores for the statement “there is often confusion about placing orders for the care of my patients in the ICU” (p = 0.001). The critical care team's management of all orders in the SICU significantly improved resident job satisfaction over the 3-year period (p = 0.027). There were no significant differences between the responses of junior and senior residents.