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. 2024 Feb 26;24(1):246.
doi: 10.1186/s12913-024-10669-x.

A qualitative co-design-based approach to identify sources of workplace-related distress and develop well-being strategies for cardiovascular nurses, allied health professionals, and physicians

Ahlexxi Jelen  1 , Rebecca Goldfarb  2 , Jennifer Rosart  3 , Leanna Graham  4 , Barry B Rubin  5
Affiliations

A qualitative co-design-based approach to identify sources of workplace-related distress and develop well-being strategies for cardiovascular nurses, allied health professionals, and physicians

Ahlexxi Jelen et al. BMC Health Serv Res. .

Abstract

Objective: Clinician distress is a multidimensional condition that includes burnout, decreased meaning in work, severe fatigue, poor work-life integration, reduced quality of life, and suicidal ideation. It has negative impacts on patients, providers, and healthcare systems. In this three-phase qualitative investigation, we identified workplace-related factors that drive clinician distress and co-designed actionable interventions with inter-professional cardiovascular clinicians to decrease their distress and improve well-being within a Canadian quaternary hospital network.

Methods: Between October 2021 and May 2022, we invited nurses, allied health professionals, and physicians to participate in a three-phase qualitative investigation. Phases 1 and 2 included individual interviews and focus groups to identify workplace-related factors contributing to distress. Phase 3 involved co-design workshops that engaged inter-professional clinicians to develop interventions addressing drivers of distress identified. Qualitative information was analyzed using descriptive thematic analysis.

Results: Fifty-one clinicians (24 nurses, 10 allied health professionals, and 17 physicians) participated. Insights from Phases 1 and 2 identified five key thematic drivers of distress: inadequate support within inter-professional teams, decreased joy in work, unsustainable workloads, limited opportunities for learning and professional growth, and a lack of transparent leadership communication. Phase 3 co-design workshops yielded four actionable interventions to mitigate clinician distress in the workplace: re-designing daily safety huddles, formalizing a nursing coaching and mentorship program, creating a value-added program e-newsletter, and implementing an employee experience platform.

Conclusion: This study increases our understanding on workplace-related factors that contribute to clinician distress, as shared by inter-professional clinicians specializing in cardiovascular care. Healthcare organizations can develop effective interventions to mitigate clinician distress by actively engaging healthcare workers in identifying workplace drivers of distress and collaboratively designing tailored, practical interventions that directly address these challenges.

Keywords: Allied health professionals; Burnout; Distress; Intervention strategies; Nurses; Occupational stress; Physicians; Well-being; Workplace factors.

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Conflict of interest statement

Ahlexxi Jelen has no competing interests. Rebecca Goldfarb has no competing interests. Jennifer Rosart has no competing interests. Leanna Graham has no competing interests. Barry B. Rubin is a member of the Steering Committee of the US National Academy of Medicine Action Collaborative on Clinician Wellbeing and is a Wellness Advisor to the Royal College of Physicians and Surgeons of Canada.

Figures

Fig. 1.
Fig. 1.
Steps of the three-phase qualitative investigation on workplace clinician distress
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