Abstract
Our work environments have a significant impact on our well-being. Stress, strain, or interpersonal challenges for workers can cause both physical and psychological impacts, including burnout (Schulte et al., 2024). It is well known that burnout has been an ongoing crisis in health care, reaching peak levels during the COVID-19 pandemic. A study of health workers by the National Institute for Occupational Safety and Health (NIOSH) compared self-reported mental health symptoms in 2018 with 2022, before and after the onset of the pandemic (Nigam et al., 2023). The study included patient-facing health care workers as well as support staff and public health workers. Nearly half of health workers (46%) reported often feeling burned out in 2022, up from 32% in 2018. However, health workers who reported positive working conditions, such as trust in management, were less likely to experience poor mental health symptoms and burnout.
Building on these findings, NIOSH launched the Impact Wellbeing™ campaign to help hospital leaders support work environments where health workers can thrive. Rather than relying primarily on building personal resilience, the campaign gives leaders tools and resources to make operational improvements to address organizational causes of burnout. The campaign encourages two-way communication between management and workers, inviting health care workers into organizational decision-making.
The signature resource of the campaign is the Impact Wellbeing Guide (the Guide), created in partnership with the Dr. Lorna Breen Heroes’ Foundation (NIOSH, 2024). The Guide launched on the inaugural Health Workforce Well-Being Day (National Academy of Medicine, 2024). It was real-world tested by hospital leaders from six hospitals within the CommonSpirit Health System across the United States.
The Guide has six actions, taking hospital leaders through a stepwise process that will support and ensure health care worker well-being.
In Action 1, hospital leaders review their hospital operations to gain a high-level summary of what efforts they already have underway. In Action 2, they build a professional well-being team. This group should be cross-disciplinary and have members from departments across the hospital, with shared decision-making authority between management and workers.
Action 3 focuses on breaking down barriers to help-seeking, which can have an immediate positive impact for health workers. For example, intrusive and stigmatizing questions on hospital credentialing applications prevent many health care workers from seeking help (American Hospital Association, 2022). In Action 3, credentialing teams audit and update questions on credentialing applications and forms to align with best practices, along with taking steps to normalize mental health challenges and identify confidential channels of support.
Action 4 develops the plan for communicating a hospital’s commitment to professional well-being, letting health care workers know how hospital leadership is working to address organizational factors contributing to burnout and providing a way for staff to share their feedback.
Action 5 integrates professional well-being into quality improvement. Professional well-being teams gather information about current administrative or operational burdens and then identify an ongoing quality improvement project to expand to include professional well-being measure(s). All activities culminate with developing a long-term professional well-being plan in Action 6. The plan should include goals for individual support, measurement, and operational improvement.
Improving the mental health and well-being of health care workers is a complex problem, but the six steps provide the path forward to greater health care worker well-being. Occupational health nurses and other occupational safety and health professionals can advocate for the use of the Guide, and have conversations with peers that normalize help-seeking. NIOSH invites all interest holders to use the Impact Wellbeing Guide and join the national movement for greater health care worker well-being.
Footnotes
Conflict of Interest
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Institutional Review Board
The user testing of the Impact Wellbeing Guide was determined to be nonresearch by the NIOSH Associate Director for Science Office. It was therefore not reviewed by an IRB. However, the user testing was voluntary and included informed consent. Feedback was de-identified to protect participants.
