There are national movements to improve the quality of primary care for patients while protecting and
promoting health worker well-being. The critical barrier to realizing these calls for action is that healthcare
systems have struggled to effectively address health worker burnout and turnover, often utilizing low-yield
tactics because of the perceived cost of system level changes. Work needs to be done to address the
fundamental problem – the healthcare working environment. In this proposal, we aim to address the work
environment of federally qualified health centers (FQHC) where critically important care is given to
underserved populations who often have multiple chronic conditions. These centers struggle with employee
retention, which leads to healthcare access and quality challenges for underserved patients. We propose a
multi-method, multi-level investigation of FQHCs to evaluate the safety, health and well-being needs of their
workforce to encourage retention. We will partner with the Colorado Community Health Network (CCHN) – all
Colorado (CO) FQHCs are members and receive support from them – as well as CO practice-based research
networks to recruit FQHCs and their staff to participate. Our project is guided by a vision for a FQHC workforce
that is thriving in an environment that fosters their well-being. Aim 1: Determine how FQHCs can utilize
leadership practices to design work that increases the employee value proposition for existing and future
FQHC staff. Aim 2: Evaluate FQHC primary care workforce well-being using the NIOSH Worker Well-being
Questionnaire (WellBQ) and assess its relationship to turnover intentions. We address AHRQ’s call to
understand approaches to support, develop, retain, and grow the primary care workforce and further
understand and improve their well-being. In the short-term, we will share results and resources with CO
FQHCs for the purpose of helping them identify strengths and opportunities in the way they are supporting their
workforce’s well-being. Our aim is to use our findings to begin to work towards shifting the current clinical
practice of FQHC’s leadership and management of provider and staff well-being towards a systems-based
approach, informed by multi-method and multi-level assessment strategies.