Burnout and network centrality as proxies for assessing the human cost of resilient performance.

The extra effort of healthcare professionals to provide care is a manifestation of resilient performance (RP), usually going unnoticed due to successful outcomes. However, it is not clear how the human cost of RP can be assessed. This study addresses this gap by investigating the relationships between proxies of RP and its human cost. The proposed approach was tested in a 29-bed intensive care unit (ICU). The centrality of each professional in the advice-seeking social network was considered as the proxy of their contribution to system resilience. A resilience score was calculated for each professional as the product of three network centrality metrics (in-degree, closeness, and betweenness) and two non-network attributes, namely their availability and reliability. Professionals' burnout was the proxy of the human cost of RP, assessed through the Maslach Burnout Inventory, composed of 22 items divided into a triad of emotional exhaustion, depersonalization, and personal accomplishment. Both questionnaires, for social network analysis and burnout, included socio-demographic questions and were answered by 99.0% of the professionals. Results indicated a weak correlation between emotional exhaustion and the resilience score (p = 0.008). This score was also weakly correlated with working overtime (p = 0.005). Overall, findings provided initial evidence that RP as measured in our study matters to burnout, and that the two proxies are exemplars of applying a more general reasoning that might be valid for other proxies.