REducing nurse burnout through SysTems analysis and Organizational REdesign (RESTORE): Evaluation of a nurse-led approach - Over half (56%) of U.S. nurses are burned out, and their burnout is associated with adverse patient care consequences, including mortality. Burnout has additional negative consequences for nurse health and well-being, including depression and suicide, and is the primary driver of turnover reported by 31.5% of nurses leaving their positions. Burnout occurs when there is an imbalance between job demands and resources in the work system. Prior efforts to address burnout among nurses have included individual-level or organizational interventions, but few have been rigorously tested. Individual-level interventions often seek to increase nurse resilience, fail to address root causes contributing to burnout, and put the onus on the nurse to fix their own burnout. Organizational interventions are generally not tailored to address unique unit-context-specific drivers of burnout, do not engage nurses in their development and implementation, and are not scalable to resource-limited settings. To address these gaps and in alignment with NINR’s NOSI to address organizational factors to prevent or mitigate nurse burnout, we propose adapting, evaluating, and exploring the scalability of the REducing nurse burnout through SysTems analysis and Organizational REdesign (RESTORE) intervention. Our scientific premise is that hospital nursing staff burnout will be reduced by: 1) identifying and addressing context-specific job demands that act as drivers of burnout, and 2) optimizing job resources for nursing staff through ownership over the design and implementation of unit-level solutions targeting burnout drivers. In our preliminary work, we conducted a system analysis of drivers of burnout for 6,000 nurses at Banner Health; however, nurses did not know how to develop solutions to address these drivers. RESTORE adapts a human-centered design approach we have previously used to develop nurse-driven unit-level solutions to address burnout. Specific aims are to: Aim 1. Adapt the RESTORE intervention to engage nursing staff in system analysis and the design, implementation, and evaluation of unit-level burnout system redesign solutions. Aim 2. Evaluate the effectiveness of RESTORE on reducing nursing staff job demands, increasing job resources, and reducing burnout. Aim 3. Identify ongoing challenges and facilitators that impact the scalability of RESTORE to engage nursing staff in system redesign and address burnout across hospital units and organizations and develop strategies for dissemination. The outcomes of this project will be a rigorously tested RESTORE intervention that can be implemented to address nursing staff burnout in hospital settings. This work addresses critical gaps in current knowledge related to how organizations can effectively use a systems approach to address nursing staff burnout. The proposed study will advance the science and contribute new knowledge related to unit-level drivers of nursing staff burnout that may be amenable to organizational interventions and system redesign, and an effective approach to engaging nurses in systems redesign to reduce burnout.
