IRB staff and managers need these survival skills

Bright lights can burn out

One of the truest sayings an IRB professional might hear is that you can't have burnout unless it's a really bright light to begin with, an expert says.

"Our IRB employees are incredibly dedicated people," says Michelle Christiano, CCRC, CIP, director of the office of human research protection at the Medical College of Georgia in Augusta, GA.

Christiano learned first-hand how terrific her staff was when the staff shrunk from nine employees to four full-time and one part-time person last summer due to maternity leave and other issues.

"We made it through the last week of June until Oct. 8, before we were back to full staff," Christiano says.

With only half the necessary staff, the IRB team bunkered down and got the work done: skipping vacations, and even bringing their children into the office to help with trivial tasks.

"I bought the kids gift cards," Christiano says, adding that she used her personal funds since the state-funded institution doesn't provide enough discretionary funds for thank-you gifts.

Christiano also recognized her hard-working staff's efforts as much as they would allow her, but there's always the prospect that people will experience burn out after such intense workloads.

So as an IRB director, Christiano has devised these strategies for preventing staff and personal professional burnout:

1. Have a passion besides work.

"Part of what you have to do is have a strong enough personality outside of the office and have something else in your life that you're passionate about," Christiano says. "You have to have a hobby and something that takes you completely away from the IRB world."

Christiano's first passion is her family, but she also has carried her IRB organizational skills and passion for protecting people to volunteer work.

Participating in volunteer work can be time-consuming, but it also can be rewarding and a way to be recognized in a more positive way than an IRB professional might experience at the job, she notes.

"So much of what we hear in the IRB office is negative," Christiano says. "We might not hear people say, 'Thank you for saving this protocol.'"

Also, volunteering can help people learn new skills.

"One of the best things I did was participate on a task force about informational technology [IT]," she says. "I volunteered even though I didn't have the time."

"When I got into it, I found that the IRB office could use information technology, and it would make our jobs so much easier than they were," Christiano says.

2. Make sure your IRB office has the right tools.

IRB offices, no matter how small, need the right tools. Some community-based IRBs don't even have a dedicated copier and/or scanner, Christiano says.

They lack the technology and software to make documentation easier, and they lack IT support when electronic documentation upgrades are needed, she adds.

Sometimes an IRB office already has the right tools, but the staff has not been informed or educated on using them, Christiano says.

Other times the institution's administrators need to be convinced that investing in new equipment is a worthwhile venture.

In either case, Christiano says the best strategy is to gather data and look for the simplest solutions. For example, the staff complained of wasting too much time walking down the hall to use the only working scanner.

The solution turned out to be a workable copier/scanner that was in the office and not being used, Christiano says. "So we called IT to have it hooked up," she says.

3. Collect data to show staff and administration.

Christiano had staff members track how much time they spent on the telephone handling certain issues. Workers had complained that these phone calls shaved hours off their days.

But when the logs were kept and the data analyzed, Christiano found that the phone calls used up far less of their time than they perceived.

So it was their perceptions that she worked on changing, armed with the data, she says.

Also, the office changed its internal forms, which caused the intake time to increase significantly, so Christiano had the staff track it.

"We're all creatures of habit, so when there's a change we say it's much easier the old way," she notes. "But when we track the data we see that the new way is much easier."

It's also important to track the time spent on protocols to see where the process is bogged down, Christiano suggests.

The IRB office is collecting three years of data that will be posted on its web site next year.

"The biggest trend is the investigators are not getting back to us in a timely manner," Christiano says. "We give them 30 days to get it back, and they take it to the 29th day."

For instance, at 3:21 p.m. on a Tuesday afternoon, Christiano notes that two protocols have been submitted for that day's 4 p.m. deadline.

"By 4 p.m., we'll have six or seven in because they wait until the last minute," she says.

4. Have managers and administrators stand behind staff decisions.

IRB workers tend to want to help out investigators by offering them breaks on deadlines, but they quickly find that the occasional one-hour late becomes a day late, and not just the rare emergency, but a trend.

This can lead to burnout.

"People have a hard time recognizing when they're burned out, and they have to say that for their own sanity the answer is 'No,'" Christiano says. "That's so hard for people to do, especially for women."

But they need to set their priorities, set their limits, she adds.

So the IRB began to enforce its deadlines to the hour, except in cases of true emergencies involving patient safety.

"When an investigator is late, the staff will say, 'I'm sorry but the deadline is 4 p.m., posted here and here — but we'll be happy to take it for next month,'" Christiano says.

Then the investigator will call the vice president of research to complain.

At the Medical College of Georgia, the top research administration and IRB officials will stand behind the staff decisions, Christiano says.

When these deadlines are enforced consistently, investigators soon will learn to respect them, and it takes unnecessary pressure off the IRB staff, she adds.

"You have to be fair and consistent — just like when raising children," Christiano says.

5. Provide whatever incentives are possible.

Even in government-funded institutions where discretionary funds are limited, there are ways to provide staff pick-me-ups.

Christiano will bring in donuts, and there's a monthly luncheon where the staff exchange recipes.

On Fridays, the office holds a "funky 15," where for 15 minutes they can listen to old music that one person selects. Everyone can sing along, Christiano says.

Also, Christiano encourages the staff to attend study coordinator meetings, which are held regularly. They can attend these for their own training purposes if they need to, or they can serve as greeters to new coordinators for the first few minutes as people enter the class.

"This way they can meet the new coordinators and put a name with the face of the person they've been talking with on the telephone," Christiano says.

When an investigator or study coordinator sends her an e-mail complimenting one of the IRB workers, she'll pass on the compliment at the staff meeting and keep the compliment in the employee's file where it will be used during the annual review.

Sometimes, all it takes is a compliment and telling a worker that she or he has done a good job, Christiano says.