People are at the heart of Critical Care Services.
To increase the understanding of burnout and team cohesiveness within Ontario’s critical care system, CCSO administers an annual Burnout and Assessment of Team Cohesiveness (ACE-15) Survey to critical care units. Through this survey, critical care team members are asked to complete the 1-Measure Burnout Survey to capture the ongoing impact of the pandemic recovery, as well as other Health Human Resource (HHR) factors contributing to burnout. In addition, staff are asked to complete the ACE-15 survey, which collects data on the perception of “teamness”. This survey is an important element informing CCSO’s HHR Strategy. The noted trends and results therein also support the evaluation of implemented initiatives and inform system-level policy investment and planning to contribute to improving the well-being of critical care staff. This report will detail the findings of the 2023 Burnout Survey and will comment on the baseline data collected for the ACE-15 survey that measures team cohesiveness, an important factor contributing to resilience and burnout among healthcare teams.
For each resource, the level of targeted utilization (eg. Critical Care Leaders, Unit Managers, or for Direct Care Providers) is indicated.
The effectiveness of these tools and degree to which any individual resource may be of value will vary between individuals and teams. CCSO does not endorse any one resource or tool over another with regard to effectiveness in addressing issues of burnout. The goal is to share potential resources for consideration by critical care teams. The following list /links to resources is by no means an exhaustive collection and will evolve over time. If you are aware of, or have used, other tools, resources or practices to address issues of burnout please feel free to forward these to CCSO for consideration of including in the list below.
If you are in crisis, talk to someone.
Crisis Services Canada
If you are in crisis there are a number of resources available. Most hospitals have an Employee Assistance Program (EAP) available 24/7. There are also local, provincial, and national resources. Nationally, Crisis Services Canada is available to you whenever you need.
An article that identifies 5 areas of focus to promote caregiver wellness.
Level of Intervention
Unit Managers
Direct Care Providers
Resilience Tools
The Center has a series of more than 15 evidence-based interactive online well-being tools that are intended to support busy healthcare workers. Tools include activities for self-compassion, gratitude, sleep, and work-life balance plus many others.
Level of Intervention
Unit Managers
Direct Care Providers
Responding to Stressful Events
A guide which identifies signs of stress for care providers as well as identifying stress relieving activities.
Level of Intervention
Unit Managers
Direct Care Providers
Self-Care for Nurses
To be able to offer the best care to patients, nurses have to make sure they’re caring for themselves. The included resources have been developed to support self-care for nurses. These resources are focused on three domains: mental well-being, physical well-being and emotional well-being.
Level of Intervention
Unit Managers
Direct Care Providers
Self-Care Toolkit
This is a collection of tools and resources to support awareness about the state of well-being for care providers. Originally created for nurses, the resources may be helpful to anyone. It starts with an inspirational video, a quality of life assessment, handouts, links to practices, apps, and ends with opportunities for continuing education credits.
Level of Intervention
Unit Managers
Direct Care Providers
Issues of Moral Distress
Goals of Care e-Learning Module
CCSO’s e-Learning Module guides care providers on how to have the end of life conversation with patients and families.
Level of Intervention
Unit Managers
Direct Care Providers
Decision Making for Escalation of Treatment
A structured framework is provided for critical care teams to support the process of decision making in end-of-life care.
Level of Intervention
Critical Care Leaders
Unit Managers
Direct Care Providers
Care at End of Life
This document provides recommendations for effective decision-making and resources. It hopes to encourage open, clear, honest discussions with patients and families enabling improved advance care.
Level of Intervention
Critical Care Leaders
Unit Managers
Direct Care Providers
Debriefing Tools
Tallk Clinical Debriefing
TALLK is designed to guide structured team self-debriefing after any learning event in clinical environments. It promotes a supportive culture of learning and patient safety.
Level of Intervention
Critical Care Leaders
Unit Managers
Direct Care Providers
Low Impact Debriefing
This 4-step process offers best practice parameters around informal debriefing. This tool offers staff exposed to traumatic/distressing experiences a structured way to debrief or offload some of the burden they just experienced in a healthy and effective way.
Level of Intervention
Unit Managers
Direct Care Providers
Debriefing Assessment for Simulation in Healthcare (DASH)
Debriefing clinical simulation experiences is increasingly understood as a crucial step in clarifying and consolidating insights and lessons from simulations. The Debriefing Assessment for Simulation in Healthcare (DASH) is designed to assist in evaluating and developing debriefing skills.
Level of Intervention
Critical Care Leaders
Unit Managers
Direct Care Providers
Patient and Family Interactions
The Patient Tool Kit: Dealing with Family
The article identifies strategies that healthcare providers can use to show professionalism and address a patient’s or family’s concerns while managing negative behaviors and defusing potentially volatile situations.
Level of Intervention
Unit Managers
Direct Care Providers
How to Deal with Patients & Families: 4 Step Action Plan
Fear can motivate a lot of difficult behaviour from family members. The author articulates 4 steps to take when dealing with these scared and seemingly difficult individuals.
Level of Intervention
Unit Managers
Direct care providers
Building Supportive Teams
Team STEPPS
TeamSTEPPS Canada™ is an evidence-based teamwork system that optimizes patient care by improving communication and teamwork skills among healthcare professionals. It includes a comprehensive set of ready-to-use materials and a training curriculum to integrate teamwork principles into a variety of settings.
Level of Intervention
Critical Care Leaders
Unit Managers
Direct Care Providers
Amazing and Awesome Rounds
Amazing and Awesome Rounds by CanadiEM relies on active participation of a care teams to identify behaviours and processes that lead to exceptional results.
Level of Intervention
Critical Care Leaders
Unit Managers
Direct Care Providers
Creating a Nurse Dream Team
Teamwork is fundamental to successful nursing care. The article provides a framework for building a cohesive nursing unit.
Level of Intervention
Unit Managers
Let us know
Do you have other resources that would make a difference to addressing burnout in critical care? Let us know, so we can share them here too.
The 2023 Burnout and Assessment of Team Cohesiveness Provincial Report provides an overview of the reported feelings of burnout among critical care teams, the ongoing impact of the pandemic recovery experience, the baseline perception of team cohesiveness, and the continuing impact of Health Human Resource challenges witnessed in Ontario within critical care. The insights gained from this Annual Report continue to inform system-level, as well as local investment and planning to improve staff well-being and retention within the Ontario Critical Care system.
