Protective Workplace Factors Influencing Burnout in Prehospital Providers Post-COVID-19.

Emergency Medical Services (EMS) providers experience high occupational stress, increasing their risk for burnout (1-7). Burnout is associated with workforce attrition, decreased job satisfaction, and diminished patient care quality (1-10). Protective factors against burnout in this population and following the COVID-19 pandemic remain poorly characterized and understudied. Our objectives were to explore how EMS provider burnout rates have changed following the COVID-19 pandemic and to identify factors that may be protective.

In 2023, an electronic survey incorporating validated instruments was distributed nationally to EMS providers using convenience sampling via organizational leadership. Quantitative data analysis included burnout outcomes measured by the Copenhagen Burnout Inventory (8), utilizing two-sample t-tests, ANOVA with Tukey HSD, and univariate linear regression.

Among 374 respondents from 34 states (mean age 48.5 ± 13.0 years; mean EMS experience 22.9 ± 12.4 years), 30.5% were female and 3.1% were underrepresented in medicine. All certification levels were present (EMR 4.3%, EMT 27.3%, EMT-I/AEMT 13.4%, Paramedic 52.1%, RN 2.4%). Among burnout subtypes, personal burnout was most prevalent (42.5%), followed by work-related (38.8%) and patient-related burnout (12.0%). Significant factors impacting burnout included meals skipped (β = 1.5, 95% CI [1.1, 2.0], p < 0.01), fatigue level (β = 0.45, 95% CI [0.37, 0.54], p < 0.001), and sleep quality ( β = -0.40, 95% CI [-0.48, -0.32], p < 0.001). Higher burnout was associated with compensation structure (full-time hourly), paramedic role, and trainer or supervisor positions (all p ≤ 0.02). Burnout did not differ by agency, system, shift, age, or geographical variations. Favorable coworker dynamics, support from supervisors, perceived equipment adequacy, and compensation satisfaction were each associated with lower burnout (all p < 0.001).

We found burnout among prehospital providers remains common following the COVID-19 pandemic and is driven primarily by workplace and intrapersonal factors, while favorable job dynamics are protective. Targeting modifiable organizational and wellness factors may present a high-yield strategy to address burnout.