Abstract
Understanding drivers of healthcare worker burnout in a rural health collaborative
Kimberly Dauner, PhD, MPH1, Julie Slowiak, PhD, BCBA-D, CHC2, Kathryn Van Wert, PhD2 and David Beard, PhD2
(1)Duluth, MN, (2)University of Minnesota Duluth, Duluth, MN
APHA 2024 Annual Meeting and Expo
Background: Healthcare facilities are seeing high turnover rates among care staff which has disproportionately affected rural areas, many of which are Health Professional Shortage Areas. High levels of burnout, characterized by exhaustion, mental distancing, and impaired cognitive and emotional functioning at work contribute to turnover. While often approached as an individual problem, organizational, system, and regional issues including understaffing, falling reimbursement, and pressure to “do more with less” contribute to burnout. Methods: We apply a continuous quality improvement approach to study worker burnout across a rural collaborative of independently-owned healthcare organizations in the upper midwest. We surveyed workers in all roles within each organization using the 12-item Burnout Assessment Tool. We held listening sessions with similar-type employees at a subset of facilities. Results: Using established cut-offs for burnout, 52.2% of our sample were at risk for burning out or suffering from severe burnout. Participants scored highest in the exhaustion dimension and for each dimension scores were higher for clinical workers, but only statistically different for the emotional impairment dimension. Significant predictors were lower organizational health climate, higher quantitative work demands, and higher emotional demands. Listening sessions revealed numerous tensions. There is tension among leadership, directly-employed staff, and those employed by staffing agencies or telehealth. Tensions stem from co-located yet independently-owned organizations, which may share staff but not resources or patient records. Managers report difficulties attracting and retaining workers in heavily-touristed areas where living costs outpace salaries. Individually, workers are challenged by caring for people they have known their whole life and relentless on-call hours. All of these drive burnout through role confusion and care gaps. Discussion: Our work revealed how burnout affects rural healthcare workers. Continuous improvement has been instructive; current work is focused on using the information to develop interventions to address burnout at the organizational level.
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