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Cited by 257Healthcare professionals’ stress and burnoutWorkplace Health and Well-beingOccupational Health and Burnout

Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review

Open access
Brand, Sarah L., Thompson Coon, Jo, Fleming, Lora E., Carroll, Lauren, Bethel, Alison, Wyatt, Katrina·2017·PLOS ONE
DOI 10.1371/journal.pone.0188418PMC PMC5714334
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Abstract

BACKGROUND: Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other sectors. There is a growing call for the 'triple aim' of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom's (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff. OBJECTIVES: This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing. METHODS: A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours. RESULTS: Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local staff needs that have extensive choice of activities to participate in (three studies). Only five of the interventions included substantial involvement and engagement of leadership and efforts aimed at up-skilling the leadership of staff to support staff health and wellbeing. Incorporation of more of the recommendations did not appear to be related to effectiveness. The heterogeneity of study designs, populations and outcomes excluded a meta-analysis. All studies were deemed by their authors to be at least partly effective. Two studies reported statistically significant improvement in objectively measured physical health (BMI) and eight in subjective mental health. Six studies reported statistically significant positive changes in subjectively assessed health behaviours. CONCLUSIONS: This systematic review identified 11 studies which incorporate at least one of the Boorman recommendations and provides evidence that whole-system healthy workplace interventions can improve health and wellbeing and promote healthier behaviours in healthcare staff.

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  • Healthcare workers report higher rates of absences due to psychological distress and job burnout than workers in other sectors.

    “Widely acknowledged as the cost of caring, healthcare workers report higher rates of absences due to psychological distress and job burnout than workers in other sectors.1–6”

    From Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. (2023) · cites this paper as [6]

    The Introduction reports markedly high rates of sickness absence, burnout, and distress among healthcare professionals compared with other sectors. It does not say that psychological distress or burnout causes the absences, as the citing sentence implies. (LLM, conf=0.84)

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Research works printed but not linked: 26

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Sorted by citations

Authors
Brand, S. L., Thompson Coon, J., Fleming, L. E., Carroll, L., Bethel, A., & Wyatt, K.
Affiliations
  • University of Exeter (GB)
  • Cardiff University (GB)
Corresponding author
Brand, Sarah L.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2017-12-04
Volume
12
Issue
12
Pages
e0188418
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0188418
PMC
PMC5714334
OpenAlex
W2773888539
Cited by
257
References
0
Citations by year
2026: 30 · 2025: 42 · 2024: 38 · 2023: 34 · 2022: 36 · 2021: 34 · 2020: 22 · 2019: 10 · 2018: 10 · 2017: 1
FWCI
2.07
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
Funders
  • Royal Devon and Exeter NHS Foundation Trust
  • National Institute for Health and Care Research
  • University of Exeter
  • European Regional Development Fund
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
healthcare worker well-being, whole systems approach, employee engagement, leadership engagement, employee health, mental health, physical health, health behavior, burnout, sick leave, hospital staff, workplace health promotion, staff distress, employee retention, personnel selection
MeSH terms
Burnout, Professional, Delivery of Health Care, United Kingdom, Health Personnel, Health Promotion, Humans, Leadership, Mental Health, Workplace

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