Factors associated with healthcare worker burnout in academically affiliated Ryan White HIV clinics in the southeastern United States

Burnout among healthcare workers can have downstream effects on healthcare systems, including less productivity, increased turnover, lower patient satisfaction, and increased costs. Providers and staff of Ryan White-funded HIV clinics (RWCs) may be particularly prone to burnout, due to complex patient needs, sizeable reporting requirements, and limited staffing and resources. We aimed to understand characteristics which contribute to and alleviate burnout at RWCs across the southeastern United States. Through a qualitative study, we conducted 20 in-depth interviews with providers, staff, and administrators of academically affiliated RWCs in the southeastern United States to explore factors impacting burnout. Participants perceived the following factors contributing to burnout: high workload, high provider involvement in patients' lives, feelings of inadequacy in providing effective care, inequitable distribution of responsibilities and opportunities, work within ineffective bureaucratic systems, and the COVID-19 pandemic. Participants perceived the following factors as alleviating burnout: a sense of comradery and feeling valued, team social activities, capacity to provide effective comprehensive care, flexible work schedules and environments, flexible enforcement of performance metrics, witness of patient resiliency, and personal factors. Findings enhance understanding of drivers of burnout within academically affiliated RWCs and inform future burnout prevention interventions.