What question did this study set out to answer?

The study assesses organizational and workplace factors related to sick leave and engagement among healthcare professionals in a Dutch academic hospital.

April 3, 2026Open Access

Sick leave and engagement as workforce well-being proxies in hospital departments: a cross-sectional study of routinely collected organisational data in a Dutch academic hospital

Key Points

The study assesses organizational and workplace factors related to sick leave and engagement among healthcare professionals in a Dutch academic hospital.
Cross-sectional analysis of routinely collected organizational data from 25 clinical departments.
Evaluation of department-level variables such as staffing capacity, inflow, and outflow of staff.
Assessment of sick leave percentage and engagement through staff surveys using a Numeric Rating Scale.
Departments with higher staffing capacity showed higher sick leave rates and lower engagement levels.
In multivariable analyses, higher staffing capacity was significantly associated with increased sick leave.
Engagement levels were positively linked to higher staff inflow and negatively linked to staff outflow.

Abstract

Objectives Well-being of healthcare professionals (HCPs) is vital for care quality, staff retention and overall healthcare system effectiveness. This study aims to identify the organisational and workplace variables associated with sick leave and measures of engagement of HCPs on department level within a single Dutch academic hospital. Design Cross-sectional study using routinely collected organisational data. Setting A tertiary-care academic hospital in the Netherlands. Participants 25 clinical departments were included. Department level variables were derived from routinely collected hospital databases. Availability of data varied across variables. Analysis included information on patient population, human resources, care processes, quality of care and employee and patient experiences to assess differences, correlations and predictors for sick leave and engagement. Primary and secondary outcome measures Primary outcome measures were (1) sick leave (%) and (2) engagement, assessed through two staff-survey items (vitality and connectedness; 0–10 Numeric Rating Scale). Both outcomes were analysed at department level. Results Employee population data showed the most consistent patterns across analyses. Departments with higher staffing capacity had higher sick leave and lower engagement in group comparisons (p=0.009, p=0.030, respectively). In multivariable models, higher staffing capacity remained associated with increased sick leave (B=1.38, 95% CI 0.53 to 2.23, p=0.003). Engagement was positively associated with higher inflow (B=0.92, 95% CI 0.06 to 1.77, p=0.037) and negatively associated with outflow (B = −1.36, 95% CI −2.08 to −0.63, p=0.001). No consistent associations were found with patient population and patient experience measures. Conclusions Workforce-related factors, particularly staffing capacity and inflow and outflow, are strongly linked to sick leave and engagement. Routinely collected hospital data can be used to identify at-risk departments and inform targeted strategies for improving workforce sustainability. Future studies should explore more granular, team-level data to better support staff well-being and care quality.

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