Work-life balance behaviours cluster in work settings and relate to burnout and safety culture: a cross-sectional survey analysis

Abstract

BackgroundHealthcare is approaching a tipping point as burnout and dissatisfaction with work-life integration (WLI) in healthcare workers continue to increase. A scale evaluating common behaviours as actionable examples of WLI was introduced to measure work-life balance.Objectives(1) Explore differences in WLI behaviours by role, specialty and other respondent demographics in a large healthcare system. (2) Evaluate the psychometric properties of the work-life climate scale, and the extent to which it acts like a climate, or group-level norm when used at the work setting level. (3) Explore associations between work-life climate and other healthcare climates including teamwork, safety and burnout.MethodsCross-sectional survey study completed in 2016 of US healthcare workers within a large academic healthcare system.Results10 627 of 13 040 eligible healthcare workers across 440 work settings within seven entities of a large healthcare system (81% response rate) completed the routine safety culture survey. The overall work-life climate scale internal consistency was α=0.830. WLI varied significantly among healthcare worker role, length of time in specialty and work setting. Random effects analyses of variance for the work-life climate scale revealed significant between-work setting and within-work setting variance and intraclass correlations reflected clustering at the work setting level. T-tests of top versus bottom WLI quartile work settings revealed that positive work-life climate was associated with better teamwork and safety climates, as well as lower personal burnout and burnout climate (p<0.001).ConclusionProblems with WLI are common in healthcare workers and differ significantly based on position and time in specialty. Although typically thought of as an individual difference variable, WLI appears to operate as a climate, and is consistently associated with better safety culture norms.

Burnout in healthcare: the case for organisational change

“…Research efforts to link the burnout and patient safety research agendas have counterintuitively focused on the performance of individuals rather than the department or practice in which they work. However, some recent research has examined the differences between organisations within healthcare,293031 and our suggestion is to go further and examine the levels of burnout in each unit within an organisation to understand key systems drivers.…”

Gratitude at Work: Prospective Cohort Study of a Web-Based, Single-Exposure Well-Being Intervention for Health Care Workers

“…Unfortunately, existing remedies for EE are limited by time, effort, and cost. For instance, mindfulness-based meditation courses have empirical support for reducing EE [ 9 ]; however, courses of this type can be costly and typically require 8 to 10 weeks and approximately 90 hours of effort from health care workers who already skip meals and breaks, deprive themselves of needed rest, and get home late as a norm [ 10 , 11 ]. In contrast, this study examines the efficacy of a brief, single-use tool—writing a letter of gratitude—for reductions in EE and improvements in well-being.…”

Speaking Up for Patient Safety: What They Don’t Tell You in Training About Feedback and Burnout

“…In this case, a PCA spoke up after witnessing a physician make a mistake. To provide a deeper understanding of such interactions, researchers analyzed data from more than 12,000 physicians’ and 11,000 PCAs’ responses to the statement, “In this work setting, it is difficult to speak up if I perceive a problem with patient care.” The results are from the most recent 250,000 responses to the Safe & Reliable Healthcare Safety, Communication, Organizational Reliability, and Engagement (SCORE) survey administered to more than 1.2 million health care workers in the United States 1-3 . Data from the SCORE survey indicate that although physicians are slightly more comfortable speaking up compared with other types of health care workers, 4-6 overall, their scores are remarkably similar to those of PCAs.…”