Work-Life Check-In Study

A Total Worker Health®, supervisor-driven burnout intervention

The COVID-19 pandemic exacerbated the long-standing problem of burnout in the healthcare industry. Evaluating strategies to address employee burnout is needed more than ever to support and retain healthcare workers.

Our study builds on a practice developed at a primary care clinic where clinic leaders met briefly (~30 min) and regularly (once per quarter) with team members to discuss how to address work-life stressors and concerns. Our semi-structured intervention will boost this practice by providing clinic leaders with training modules on how to implement the check-ins, how to demonstrate behaviors that support employees, and the basics of quality improvement cycles, and by offering feedback and troubleshooting as clinics address identified issues.

Our hypothesis is that the Work-Life Check-In meetings will reduce burnout by enhancing supervisor support, trust, and value alignment, increasing awareness of resources, and addressing workflow or work-life problems. We will test this hypothesis with a cluster randomized controlled trial enrolling several primary care clinics. 

The aims of the study are to:

1) determine the 12-month effectiveness of the Work-life Check-ins in reducing burnout and secondary outcomes such as turnover intentions.
2) identify with a mixed-method approach the organizational changes produced by the work-life check-ins, including documenting how each clinic decided to address stressors at their local context.

Burnout, a work stress syndrome characterized by emotional exhaustion, cynicism and feelings of low accomplishments, is highly prevalent in healthcare, and the pandemic has only added to the issue. At the worker level, burnout increases the risk of depression and other mental health disorders, cardiovascular diseases, and risk of occupational injury. Outside of work, burnout can impact worker’s families and communities through work-life conflict and social isolation.  And at the organizational level, burnout can impact productivity and turnover, diminishing the quality of patient care and safety.

While the need for systemic reform remains urgent to curtail burnout in healthcare, our study is important because we expect to provide a fast-acting, non-resources intensive simple and meaningful approach to address burnout in healthcare. Our intervention trains clinic leaders to acknowledge and modify work-life stressors according to their level of influence and control.

Our pilot work indicates that the check-ins are feasible to implement and effective in reducing burnout. The check-ins were more successful when clinic leaders respected personal boundaries and confidentiality, centered the conversations around employees’ concerns, and follow-through with action plans to address a problem. Our pilot work also underscored how important is for employees to feel listened to, even when the solution to a problem is outside the control and power of their team leader. The findings from our pilot study indicate that the check-ins contributed to a reduction in burnout levels at this clinic.  The check-in process will be adapted to incorporate a Total Worker Healthâ informed approach to supervisor-employee interactions to reduce hazards and increase protective resources related to burnout. This study also incorporates prior research and trainings on Family Supportive Supervisor Behaviors.

Funding for this study is provided by a grant from the National Institute for Occupational Safety and Health.

Abigail Lenhart, MD Associate Professor, Division of General Internal Medicine and Geriatrics

Abigail Lenhart, MD
Associate Professor,
Division of General Internal Medicine and Geriatrics

David A. Hurtado, ScD, Assistant Professor, Oregon Institute of Occupational Health Sciences, OHSU

David Hurtado, Sc.D.
Assistant Professor,
Oregon Institute of Occupational Health Sciences
Assistant Professor,
OHSU-PSU School of Public Health

Leslie B. Hammer, PhD, Professor, Associate Director for Applied Research and Co-Directoer Oregon Healthy Workforce Center, Oregon Institute of Occupational Health Sciences, OHSU

Leslie Hammer, PhD
Professor,
Oregon Institute of Occupational Health Sciences
Co-Director,
Oregon Healthy Workforce Center,
 

Teresa Everson, MD Multnomah County Health Department

Teresa Everson, MD
Multnomah County Health Department

Miguel Marino, PhD Associate Professor of Family Medicine, School of Medicine Associate Professor, OHSU-PSU School of Public Health

Miguel Marino, PhD
Associate Professor,
Family Medicine, School of Medicine
Associate Professor,
OHSU-PSU School of Public Health

Rachel Madjilesi,

Rachel Madjlesi, MPH
Research Project Manager
Oregon Institute of Occupational Health Sciences

Dam Greenspan, MPH

Sam Greenspan, MPH
Research Assistant
Oregon Institute of Occupational Health Sciences

Jackie Boyd

Jackie Boyd, MPH
Research Project Coordinator
Oregon Institute of Occupational Health Sciences