Healthcare workers’ perspectives on burnout complaints: exploring underlying dynamics using a complex systems approach

Abstract Background Healthcare workers (HCWs) report burnout complaints more often than the general workforce, leading to reduced quality of life and delivered care, high absenteeism and associated costs. Addressing the complex issue of burnout complaints requires a shift from linear thinking to a systems perspective focused on interaction and feedback. This study explores the dynamics behind burnout complaints by approaching it as a complex system, from the perspective of Dutch HCWs. Methods Thirteen HCWs from eight different professions participated in two Group Model Building sessions to develop a Causal Loop Diagram (CLD). Participants identified contributing factors related to living conditions, working conditions, and societal developments, and mapped their assumed relationships into causal feedback loops. Results The CLD contains 24 factors, 55 assumed causal relationships, and 417 feedback loops. Within these loops, two reinforcing and two balancing key dynamics were identified. The perceived reinforcing dynamics illustrate how burnout complaints and staff shortages amplify each other, and how rising burnout impairs care quality, prompting patient dissatisfaction that further increases burnout complaints. The perceived balancing dynamics reflect how this cycle is partially mitigated by supportive leadership and rising societal awareness, which improves working conditions and employment terms. Conclusions According to HCWs, these dynamics may help explain the rising trend in the prevalence of burnout complaints among HCWs. Understanding these dynamics offers valuable insights for developing more effective strategies to shift the system towards more favorable outcomes.