Expert prioritisation of perceived drivers of quiet quitting in Indian healthcare organisations

Quiet quitting describes sustained limits on discretionary effort while employees continue their required duties. The phenomenon may be especially consequential in healthcare, where coordination, continuity, and voluntary support affect care delivery. Yet its possible drivers have rarely been prioritised within Indian healthcare settings. We used a sequential modified Delphi and group analytic hierarchy process (AHP). A literature review identified 23 candidate drivers. Twenty-three senior healthcare experts completed four Delphi rounds. Selection required a median of at least eight and a standard deviation not exceeding 1.00. Eleven drivers met the retention criteria. Fifteen experts subsequently completed the AHP pairwise comparisons. Their judgements were aggregated using an equal-weight geometric mean. All 15 individual matrices met the predefined consistency criterion of CR ≤ 0.10, while the aggregated group matrix had a CR of 0.0605. Burnout and Emotional Exhaustion was the highest-ranked perceived driver (0.2217), followed by Work–Life Imbalance (0.1998) and Understaffing and Resource Constraints (0.1277). Together, these three drivers accounted for 54.92% of the total priority weight. Expert rankings showed strong concordance (Kendall’s W = 0.9602). Leave-one-expert-out analyses preserved the complete group ranking, while bootstrap resampling placed Burnout and Emotional Exhaustion first in 90.55% of samples. All professional subgroups produced the same complete rank order. Consequently, burnout and work-life imbalance should form one intervention tier. Hospitals should connect staffing decisions, scheduling reform, workload control, managerial support, and protected recovery time. However, our findings reflect expert priorities and do not establish causal effects.