Protocol to examine the feasibility and acceptability of a randomized controlled trial of a chaplain-delivered compassion intervention to improve psychological safety among interprofessional healthcare teams.

backgroundHealthcare provider burnout is pervasive, imparts harm to providers and patients, increases healthcare and workforce disparities, and exacerbates physician and nursing shortages. Although burnout is primarily caused by organizational stressors, supportive and cooperative interdisciplinary teams foster psychological safety and are protective against burnout. To address the critical and unmet need for evidence-based, acceptable, and scalable interventions to improve burnout, this study will evaluate the feasibility and acceptability of the Compassion-Centered Spiritual Health Team Intervention (CCSH-TI), a novel team-based intervention delivered by healthcare chaplains embedded within the interprofessional team. Using CCSH-TI, chaplains teach mindfulness and compassion-based approaches designed to bolster compassion for self and others and to improve psychological safety and team civility.

methodsThis study will utilize a phase 1 clustered randomized, "standard of care" (SOC) controlled, and mixed-method design to examine the feasibility and acceptability of CCSH-TI. Employees (n = 80; nurses, advanced practice providers (APPs), physicians, staff) working at a National Cancer Institute-Designated Comprehensive Cancer Center will be randomized by team to CCSH-TI or to SOC. We will evaluate CCSH-TI feasibility (accrual, retention, CCSH-TI attendance) and acceptability (satisfaction, credibility, perceived benefit). Focus groups will identify contextual determinants of feasibility, acceptability, and implementation success. Prior to and after the intervention, as well as at 12-week follow-up, we will conduct 3-day ambulatory assessments: (1) ecological momentary assessments (EMA) of social connection, incivility, and burnout and (2) electronically activated recorder (EAR), a naturalistic observation method that samples ambient sound from participants' momentary environments used widely outside healthcare settings. We will develop and validate EAR behavioral codebooks tailored to the healthcare environment to quantify behavioral indices of psychological safety, incivility, and interprofessional teamwork. DISCUSSION: This study will provide data on the acceptability and feasibility of a chaplain-delivered team intervention for interprofessional healthcare teams working in oncology. The findings will inform the design of a future study to examine this innovative and scalable approach to increase access, equity, and inclusion of burnout prevention and mitigation among all healthcare providers. Additionally, this work will improve the scientific rigor of research on burnout by developing a novel, objective, and low-burden assessment toolkit. Name of the registry CCSH (Compassion-Centered Spiritual Health) for Teams Trial registration number NCT06722027 Date of registration December 9, 2024 URL of trial registry record https://clinicaltrials.gov/search?term=NCT06722027.