How healthcare staff morale affects patient safety and care quality as observed by burnout, stress, well-being, and support

1. How Healthcare Staff Morale
Affects Patient Safety and
Care Quality as Observed by
Burnout, Stress, Well-being,
and Support
Research Question
Todd L. Smith II, MBA, CALM

2. Job Morale Defined
• A widely applicable term with inconsistent definitions (Sabitova et al., 2020)
• Applied to individuals and groups
• Caravella (2016) described morale as the level of confidence and
enthusiasm observed by an individual or groups at a specific time
• Umbrella conceptualization embodying work-related factors
such as burnout, well-being, workload, job demand, stress,
and satisfaction (Sabitova et al., 2020)

3. Theme One
Stress and Burnout Associated with
Morale and Satisfaction

4. Stress and Burnout Associated with Morale and
Satisfaction – Scholarly Text
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•
•

5. Focus.
Method.
Findings.
Nocon (2019) measured baseline data against
post-intervention results to determine a patient-
centered medical home model's success.
Nocon (2019) examined changes in staff morale,
burnout, and job satisfaction post-intervention.
Method: surveys to over five-hundred staff members
from sixty clinics, rating their morale, satisfaction,
and burnout levels after the intervention.
Findings: in some instances, there were decreased
rates of satisfaction and an incline of burnout. More
excellent patient-centered medical home scores
were not significantly linked to positive morale,
satisfaction, or lesser burnout levels.

6. Focus.
Method.
Findings.
Turnell (2016)
rationalized that
engagement was a
critical factor
offsetting high stress
in an oncologist
group's workplace
environment.
Turnell (2016)
focused on job stress
and burnout,
affecting the well-
being of
psychological
oncologists.
Measures were
conducted
considering burnout,
emotional
exhaustion,
engagement, job
demands/resources,
and other factors
(Turnell et al., 2016).
Findings expounded
on resources and
demands as having a
positive and negative
effect on workplace
factors contributing
to burnout and work
engagement.

7. Focus. Method. Findings
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•
•

8. Theme Two
Support Systems are Positively linked
to Job Morale and Satisfaction

9. Support Systems are Positively linked to Job
Morale and Satisfaction. – Scholarly Text
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•
•

10. Focus.
Method.
Findings.
Findings were centered on thirteen emergent elements, which
were compartmentalized under five categories, namely "sense
of community, individual motivators, clinical work, feeling cared
for, and trust in the administration" (Caravella et al., 2016).
Caravella’s (2016) method conducted qualitatively featured
analysis techniques to pinpoint trends relevant to well-being
and morale among various postgraduate levels of residents.
Caravella (2016) rationalized the misunderstanding of morale
throughout the journey for medical students.

11. Focus.
Method.
Findings.
Dowling (2019) focused on ongoing
education and small group learning
for general practitioners and the
impact that the sense of community
had on morale.
Qualitative method: interviews during
a small group learning setting in four
different rural geographical locations
(Dowling et al., 2019)
found that the general practitioner
population viewed the small learning
groups and community support as a
stress reducer and critical to
enhanced morale

12. Focus. Method. Findings
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•
•

13. Theme Three
• Patient Safety and Care Quality is Connected
to Staff Burnout and Wellbeing

14. Focus. Method. Findings.
Dewa's (2017) focus was centered on the connection between patient
safety, the quality of care, and burnout among residents.
Dewa (2017) filtered through over four-thousand articles and narrowed
the study down to eight articles total. The articles represented the body
of work based on burnout among residents and care quality.
Studies produced from Dewa’s (2017) search revealed evidence that
the connection between burnout and patient safety exists.

15. Focus.
Method.
Findings.
Hall (2016) focused on the
possibility of an association between
well-being and burnout with the
patient safety
Hall's (2016) method was a
systematic search considering
literature encompassed around
factors related to burnout, well-being,
and patients' safety.
Self-reported medical errors
regarding patient care were linked to
decreased well-being and increased
burnout among staff through various
studies searched by Hall (2016).

16. Focus. Method. Findings.
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•
•

17. Intervention Effectiveness –
Rivett’s (2019) Systematic
Review
• Connected inadequate training to staff's potentiality,
not feeling competent and confident enough to
accommodate some critical factors of caring for
dementia residents.
• Identified burnout and stress as factors related to the
staff's lack of competency and confidence, potentially
disengaging from patients inappropriately
• Examined the literature to find that demoralization
and reduced morale correlate to staff turnover, posing
financial risks, and service compromising variables.

18. Intervention Effectiveness in a
Dementia Care Setting
• Borbasi’s (2011) study centered on a coaching style intervention for
healthcare workers in an outreach service setting
• Teaching staff members management skills related to behavioral and
psychological symptoms of dementia
• Borbasi (2011) found that staff confidence was increased and captured a
reduction in the program’s patient admissions to the emergency room

19. Intervention Effectiveness in a
Dementia Care Setting
• Hoeffer’s (2006) study connected
healthcare workers' confidence through
bathing and showering routine intervention
for staff concerning resident hygiene care
• The intervention led to increased verbal
reinforcement and increased instances of
thoughtful and delicate approaches to the
hygiene routine for residents by staff
members.

20. Intervention Effectiveness in a
Dementia Care Setting
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•

21. Intervention Effectiveness in a
Dementia Care Setting
• Williams (2016) examined a communication-focused intervention that
aimed to decrease elderspeak factors and found that the intervention
caused the staff's view of self-confidence to reduce significantly
• Bhaduri’s (2006) research on a person-centered approach intervention
regarding behavioral and psychological symptoms of dementia found that
staff was more confident in understanding and applying communication
regarding dementia afterward

22. Intervention Effectiveness in a
Dementia Care Setting
• Roberts (2013) research articulated an inclination of
confidence among staff members and enhanced
understanding and commitment to care quality
post-palliative training intervention.
• Franzmann (2016) examined a social competency
and communication intervention that enhanced staff
capability levels during a six-month follow-up study
• Franzmann’s (2016) study found that the
intervention decreased stress-related factors in the
healthcare work environment

23. Intervention Effectiveness in a
Dementia Care Setting
•
•

24. Intervention Effectiveness in a
Dementia Care Setting
• Finnema’s (2005) research articulated findings related to a competency intervention centered on
emotion-oriented staff care; however, the author did not find any significant increases of self-
perceived healthcare worker competency afterward
• Goyder’s (2012) examination of a communicative capabilities intervention found no evidence of a
positive impact on competency

25. Intervention Effectiveness in a
Dementia Care Setting
• Guzman (2016) focused on a positive
psychology approach as an intervention,
but with minimal results toward positive
staff competency levels.
• However, the study produced positive
results for relationship building and
demonstrated enhanced confidence
among healthcare workers (Rivett et al.,
2019).

26. Intervention Effectiveness in a
Dementia Care Setting
• Teri (2005) examined a skill-based
intervention for staff members but found
minimal results for positive staff
competency levels post-intervention.
• Hobday’s (2010) study featured a training
module online as an intervention strategy
for late-stage dementia competency.
• Healthcare workers self-reported increased
competency and confidence related to care
capabilities and communicative
interactions with the residents (Hobday et
al., 2010).

27. Future Implications and
Interventions
• Nguyen (2017) implied that organizational-based interventions were critical for
increasing job satisfaction among healthcare staff members.
• Increasing the company culture's quality with positive reinforcements would be
instrumental for employee commitment and motivation to perpetuate high-quality
performance.
• The author articulated the need for an intervention dealing with staff development
and increasing healthcare workers for balancing the workload when considering
morale and satisfaction.

28. Future Implications and
Interventions
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•
•

29. Conclusion
• Team-centered implementation and interventions grounded on coaching and
inclusive support seemed to be the most effective for combatting emotional
exhaustion, role ambiguity, feelings of isolation, stress, and declining morale.
• Future implications for the research include examining specific evidence-based
intervention effectiveness for increased morale concerning healthcare
organizations and professionals.
• Evidence widely suggests that patient care, safety, and outcomes depend on staff
members' well-being who are instrumental in treatment processes.

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