8220273 The perspective of Dutch healthcare providers on mechanisms underlying burnout symptoms – a complex systems approach

<h3>Objective</h3> Healthcare providers report burnout complaints significantly more often than other professional groups, leading to consequences such as reduced quality of life and care, high absenteeism and associated costs. Despite broad recognition of this phenomenon, there has been a rising prevalence over the past ten years. Addressing this complex issue requires a shift from linear thinking to a systems perspective—focusing on interaction and feedback. The objective of this study is to explore the mechanisms behind burnout complaints by approaching it as a complex system, from the perspective of healthcare providers. <h3>Material and Methods</h3> Thirteen healthcare providers from eight different professions were recruited through a combination of convenience and snowball sampling. They participated in two Group Model Building sessions to develop a Causal Loop Diagram (CLD). During these sessions, participants identified factors related to living conditions, working conditions, and societal developments that contribute to burnout complaints and indicated their assumed relationships resulting into causal feedback loops. <h3>Results</h3> The CLD contains 24 factors, 55 assumed causal relationships, and 46 unique feedback loops. These were grouped into three overarching themes: one reinforcing and two balancing. The reinforcing theme illustrates how burnout complaints and staff shortages mutually amplify one another through multiple mechanisms - for example, burnout-induced absenteeism can increase workloads, undermine decision latitude and job satisfaction, and thereby perpetuate burnout. The two balancing themes reflect how this vicious cycle is partially offset by supportive leadership, like aligning responsibilities with competences, and rising societal awareness, leading to improvements in working conditions and employment terms. <h3>Conclusion</h3> According to healthcare providers, these complex interacting mechanisms help explain the rising trend in the prevalence of burnout complaints within the sector. Understanding these mechanisms offers valuable insights for developing more effective, system-oriented strategies to address burnout complaints among healthcare providers.