Burnout and Satisfaction Affect Work Effort

Liselotte N. Dyrbye, M.D., M.H.P.E.

Burnout and professional satisfaction of healthcare workers are associated with subsequent changes in work effort over the following 24 months.

Findings of the new study highlighted the importance of addressing factors contributing to high stress among all healthcare workers for workforce retention and cost reduction.

Liselotte N. Dyrbye, M.D., M.H.P.E., and an investigative team explored the association of burnout and professional satisfaction with changes in work effort over two years in a large cohort of nonphysician healthcare workers. A link to a survey was administered to all employees at Mayo Clinic in October 2015 and 2017. The survey sample included healthcare workers who were nonphysician professionals, administrative office support workers, business professionals, clinical office support workers, service and support workers, and technicians and technologists. Among those who received the surveys, more than 26,000 completed both and were included in the analysis.

To collect work effort, administrative and payroll records were retrieved. On the survey were two items from the Maslach Burnout Inventory used to measure emotional exhaustion and depersonalization. Those with a high score on either item were considered to have symptoms of burnout.

The survey had one item assessing professional satisfaction. Respondents were asked, “Considering everything, how would you rate your overall satisfaction with Mayo Clinic as a whole at the present time?” using a five-point Likert scale — one indicated very dissatisfied; five indicated very satisfied.

Among participants, a majority were women (77.1%), 27.8% were 45-54 years old, most were employed less than five years (32.6%) or more than 15 years (30.9%), and 25.1% were nurses. At baseline, 21.9% of respondents had high emotional exhaustion, 9.2% had high depersonalization, and 23.8% had overall burnout. Of those who rated their baseline satisfaction, most were very satisfied (35%) or satisfied (51.1%) with the organization.

Only 8.2% of respondents reduced their work effort between 2015 and 2017. A majority of those who reduced their work effort were younger than 35 years old (42.2%), women (89.7%), and had less than five years of employment (42.4%). More than half of those who reduced their work effort were nurses. For those who reduced their work effort, the mean reduction was 21% and among nurses, the mean reduction was 18.7%.

Participants who had burnout in 2015 were more likely to reduce their work effort over two years than those without burnout (10.5% vs 6.7%). Higher frequencies of emotional exhaustion and depersonalization symptoms were associated with greater prevalence of reduction in work effort. Lower satisfaction with the organization was associated with higher prevalence of reduction in work effort.

Further research is needed to determine causal relationships among identified factors and how best to improve the work environment to mitigate burnout and decreased satisfaction.

The study, “Characterization of Nonphysician Health Care Workers’ Burnout and Subsequent Changes in Work Effort,” was published online in JAMA Network Open.