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QUERI Examines VA Staff Burnout and Retention
Amy Kilbourne, PhD, MPH, Director of QUERI
Workforce wellbeing is essential to Veteran health, especially with the growing concern regarding provider burnout with the COVID pandemic, coupled with labor shortages, medical supply chain disruptions, and overall economic uncertainty. The development, retention, and wellbeing of VA’s workforce are growing priorities within the VA healthcare system and bring forth opportunities to further disseminate, implement, and evaluate programs and policies that support our employees. Moreover, workforce wellbeing is part of the Quintuple Aim that includes provider experience along with equity, population health, quality, and value (Nundy et al., 2021).
In February 2022, VA Secretary Denis McDonough announced several initiatives to support VA’s federal workforce. Secretary McDonough’s Human Infrastructure plan not only addresses the growing concern regarding employee burnout, but also establishes more opportunities, particularly for under-represented populations. Key initiatives include better prospects for promotion, increased focus on diversity, equity, and inclusion, as well as increased efforts to reduce burnout and promote work-life balance. VA also recently launched the Reduce Employee Burnout and Optimize Organizational Thriving (REBOOT) Task Force which includes a rollout of promising practices that have the potential to address employee burnout (e.g., self-care protected time for VHA employees, employee peer support, flexible work schedules, reduction in mandatory TMS training requirements). Further, VA’s Office of Research and Development (ORD) is focused on recruiting and retaining an embedded and diverse research workforce. Overall, workforce wellness has gained traction as a major policy and evaluation priority in the federal government, notably through expansion of paid internships, increased promotion opportunities, and a revisioning of infrastructure to include service providers (i.e., caregivers).
Not surprisingly, workforce wellbeing was one of the top VA priorities that directors of Veterans Integrated Services Networks (VISNs) identified in the annual QUERI live voting of healthcare priorities for its Partnered Implementation and other initiatives. Other priorities are closely related and include:
- Improving clinical care efficiency (e.g., administrative, technology, supply chains);
- Strategies to mitigate the long-term impact of COVID-19 delays in care, especially for preventive services; and
- Implementing standards of care for VA and community-based services through the MISSION Act.
Our QUERI investigators featured in this issue are taking on challenging and vital evaluation efforts to better understand how to promote workforce wellness, particularly in light of the modernization of VA’s electronic health record and VA trainee workforce retention.
While essential to the dissemination, implementation, and quality of healthcare best practices, until recently, workforce research has not been a major focus among federal funders, with the possible exception of studies focused on implementation. Rigorous research and evaluation of programs and policies will be needed given the growing interest in the federal government toward policy-level strategies to improve health and promote equity. Many of these initiatives are broad and top down – and will require rigorous evaluation to ensure their effectiveness, sustainment, and equity in opportunity. It will also challenge us, as implementation and evaluation scientists, to expand the boundaries of what we do to inform change at the organizational and policy levels in order to ultimately impact employee health and health outcomes among Veterans.
Amy Kilbourne, PhD, MPH
Director, Quality Enhancement Research Initiative
Melissa Braganza, MPH
QUERI Program Manager