“It changed the atmosphere, but how long will it last?”: healthcare professionals’ experiences of an intervention to improve positive communication in intensive care

TL;DR

This study explores how healthcare workers in intensive care units experienced a communication intervention aimed at reducing burnout and improving teamwork.

Contribution

The study provides qualitative insights into the sustainability and impact of a low-cost communication intervention in ICUs.

Findings

Participants reported improved team cohesion and workplace atmosphere due to the intervention.

Leadership engagement was identified as a key factor in successful implementation.

Barriers like workload and skepticism limited long-term sustainability of the intervention.

Abstract

Burnout among healthcare professionals (HCPs) working in intensive care units (ICUs) has reached alarming levels, with detrimental effects on staff well-being, patient care, and organizational functioning. The HELLO randomized controlled trial (RCT) tested a multicomponent intervention aimed at reducing burnout by promoting positive communication and teamwork. This qualitative study complemented the RCT by exploring participants’ experiences and perceptions of the intervention, identifying barriers, facilitators, and factors influencing sustainability.

This qualitative component was conducted alongside the HELLO cluster-RCT in ICUs across multiple countries. Data sources included (1) 1,155 pictures of messages placed in “HELLO” boxes and on noticeboards, and (2) 26 semi-structured interviews with 27 ICU professionals from 18 ICUs, conducted 4–5 months after the intervention. Data were analysed using thematic analysis.

Box messages from 26 ICUs in 20 countries revealed recurrent themes of appreciation, recognition, kindness, teamwork, and motivation, often expressed through short, personal notes of gratitude or encouragement. Interviews identified six overarching themes: understanding of the intervention and initial reactions; facilitators and barriers to implementation; focus on messages; local adaptations; immediate positive outcomes; and long-term potential outcomes. Participants reported improved team cohesion, communication, and workplace atmosphere, with leadership engagement emerging as a key facilitator. Barriers included scepticism, workload, and pre-existing workplace tensions. Although many perceived short-term benefits, most noted that the effects diminished over time unless reinforced through continued initiatives.

This qualitative study provides insight into healthcare professionals’ experiences of the HELLO intervention, highlighting perceived improvements in communication and team atmosphere, as well as challenges related to engagement, workload, and sustainability. These findings can inform future adaptations and implementation strategies for similar low-cost interventions in intensive care units.

ClinicalTrials.gov NCT06453616 (June 18, 2024).

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