Burnout and staff experiences of health inequalities in children's hospitals: a qualitative analysis.

Abstract

To identify burnout constructs from descriptions of staff experiences of health inequalities operating across paediatric specialist hospitals and to categorise the constructs according to Leiter and Maslach's six Areas of Worklife (AWL) model of burnout. A secondary data analysis of a qualitative study using semi-structured interviews and focus groups. The interviews and focus groups were conducted within nine children's hospitals in England. The dataset included responses from 217 individual staff members occupying various roles: leadership, clinical, professional and support. All staff who volunteered to participate were included in the study. The results of this exploratory analysis showed that psychological burnout constructs were frequently embedded in hospital staff's descriptions of their experiences of health inequalities in hospitals, and relevant excerpts were found for all six domains of the AWL model. Staff described a work environment where socioeconomic disparities increased workload pressures, but efforts to improve services were frustrated by a perceived lack of control in decision making or professional recognition. There was ambiguity of role-based responsibilities for tackling health inequalities and an imbalance between organisational practices and personal and professional values of social justice. There is a reciprocal relationship between health inequalities and burnout experienced by healthcare professionals operating within specialist children's hospital settings. The extant knowledge and approaches to health inequalities and occupational burnout should be considered in tandem, integrated into quality improvement and operationalised within paediatric healthcare organisations to improve safety and quality of care.