Investigating Frontline Healthcare Worker Burnout at a Critical Access Hospital by Applying Appreciative Inquiry

Abstract

Increased stress level due to the Coronavirus disease 2019 (COVID-19) has led to a rise in burnout among frontline staff (Jalili et al., 2021; Willard-Grace et al., 2019). Burnout has been defined as emotional exhaustion, cynicism, and a feeling of low personal accomplishment (Dinibutun, 2020; Koutsimani et al., 2019). Few studies have investigated frontline healthcare workers' stress and burnout levels within the context of a rural setting, such as a critical access hospital (CAH) (Bethea et al., 2020; Cook et al., 2021; Terry & Woo, 2020). Critical access hospitals are small hospitals of 25 beds or fewer with limited financial and clinical resources. Additional research is needed to explore the burnout experience among staff at CAHs (Bethea et al., 2020; Cook et al., 2021). The purpose of this explanatory mixed methods study aims to examine frontline health workers’ perceptions of burnout and coping mechanisms during the pandemic and how administrators perceive burnout among staff. Participants completed the Maslach Burnout Inventory (MBI) questionnaire in the quantitative phase. The results of the questionnaire indicate that staff have a negative perception of the work environment and that many individuals were burned out. In the qualitative phase, staff were interviewed using a guide centered on the Appreciative Inquiry (AI) framework. Five themes emerged that indicate the mechanisms that contribute to higher engagement. Finally, the hospital administrators were interviewed to understand leaders’ perspectives on burnout, wherein four themes emerged around how best to support frontline healthcare workers. The information was then developed into a burnout reduction framework that may assist CAHs in understanding strategies to mitigate burnout among frontline healthcare workers.