Can workplace check-ins reduce emotional exhaustion among employees in primary care clinics?

Healthcare worker

The emotional stress, fatigue, and levels of burnout experienced by healthcare workers, both before and in the wake of the COVID-19 pandemic, have been well documented. As a result, many healthcare workers have left the profession, placing additional strain on an already overburdened healthcare system. 

Seeing a potential crisis for the healthcare industry and workforce, US Surgeon General Vivek Murthy has prioritized addressing burnout and well-being among healthcare workers. In an op-ed in The New England Journal of Medicine, Dr. Murthy noted: “More than half of health workers report symptoms of burnout; many are contending with insomnia, depression, anxiety, post-traumatic stress disorder, or other mental health challenges.” Additionally, Murthy attributes projections of shortages of healthcare workers numbering in the millions to burnout. 

Recent research suggests short and frequent check-ins between healthcare workers and their supervisors might be a practical and effective tool to reduce emotional exhaustion–a key feature of employee burnout–in primary care clinics. The article “Promise and Perils of Leader-Employee Check-ins in Reducing Emotional Exhaustion in Primary Care Clinics: Quasi-Experimental and Qualitative Evidence” is available in the June 2023 issue of Mayo Clinic Proceedings. Assistant Professor David Hurtado, ScD (Oregon Institute of Occupational Health Sciences) and Associate Professor Abigail Lenhart, MD (Oregon Health & Science University, School of Medicine) co-authored the article with colleagues Samuel Greenspan, Steel Valenzuela, Wendy McGinnis, and Teresa Everson. 

The paper details findings from three interrelated studies investigating emotional exhaustion among workers at primary care clinics. According to Hurtado and Lenhart, emotional exhaustion is feeling worn out due to chronic work stress and is a critical component of burnout. 

During preliminary analyses of the data, the research team discovered that among the clinics participating in the study, one showed lower levels of employee emotional exhaustion. Curious, the research team inquired about what this clinic was doing that the others were not—the answer: leader-employee check-ins in which leaders listen, acknowledge, and address work stressors. Equipped with this insight, the researchers designed a study to evaluate the effectiveness of check-ins on emotional exhaustion. The study involved developing tools to assist leaders in facilitating check-ins and follow-up interviews with participants. 

As reported in the article, the team found that short (10-30 minutes), frequent (several times a year), and confidential conversations between leaders and employees may reduce emotional exhaustion, particularly in the first year of engagement. The team notes that these check-ins are separate from traditional employee performance reviews. Additionally, the team found that meetings increased values alignment between leaders and employees and that scheduling and conducting the check-ins did not result in additional administrative burdens. However, the team found that unwanted outcomes could result without proper guardrails to separate work and personal life issues. The team addresses this issue by developing additional materials to support leadership engaging in the one-on-one check-ins. 

“I am very drawn to the idea of leader-employee check-ins as they fall in that sweet spot of low effort and high impact,” Hurtado said. “This is what you’re looking for in terms of workplace interventions, especially in healthcare where there are so many competing demands.” 

The research team is currently rolling out the next phase of the study with a randomized controlled trial with more resources, including online training modules to support effective engagement among leaders in primary care clinics. 

“I think these check-ins are promising,” Lenhart said. “I think the theory behind them and the early evidence we’ve gathered suggests that they are a potential tool to help address emotional exhaustion and other drivers of burnout.”  

As Surgeon General Murthy notes, addressing the mental health crisis plaguing many healthcare workers is essential to the overall health and well-being of the general population. Together Hurtado, Lenhart, and colleagues are working to find practical solutions to this ongoing problem. While the research team is still in the process of the next phase of the study, including developing and evaluating tools for implementing successful workplace check-ins, the paper provides valuable information about the check-in process, including an overview of the steps involved and is open access and available to download for those interested in learning more.