Organisational factors contributing to staff burnout in aged care

Burnout is a complex occupational phenomenon that is influenced by organisational, personal, and interpersonal factors. [1] In this theme, organisational factors refer to the various interconnected elements within an institution that collectively influence the behaviour and functioning of an organisation (i.e., aged care). [1] Within aged care, there are specific organisational factors that contribute to an increased risk of burnout among aged care workers. [2] Identifying these factors can assist organisations to reduce the risk of burnout among their workers, promoting healthier and more sustainable workplaces. [1, 2] This not only benefits the wellbeing of the aged care workers, but also enhances the quality of care provided to clients/residents, ensuring a more positive care delivery. [1, 2]

Personal and interpersonal factors are discussed in separate evidence theme reports.

This evidence theme on organisational factors is a summary of one of the key topics identified by a scoping review of the burnout research. If more specific or comprehensive information on this topic is required, use the PubMed searches provided below. 

The 2022 scoping review found nine studies on organisational factors contributing to burnout among aged care workers. [3-11] The 2023 update found an additional three studies that contributed to this theme. [12-14] The stressful nature of aged care workplaces (i.e. work conditions) may contribute to burnout for aged care workers. [12]  These work conditions can be divided into two categories, namely, work demands and work-related stressors.

A list of reported work demands contributing to one or more burnout components in aged care include:

• Heavy and increased workloads. [4, 6, 8]
• High acuity of residents. [4]
• Long working hours. [3]
• Time pressures. [3, 5]

A list of reported work-related stressors to one or more burnout components in aged care include:

• Insufficient time to perform tasks for residents. [4]
• Professional responsibilities and role conflict. [6]
• Lack of materials and resources (i.e., towels) to support the care workers to do a ‘good job’. [6, 15]
• Lack of belief in the quality of care provided by the organisation. [11]
• Lack of opportunities for continuous education [8] (for registered nurses). [7]
• Dissatisfaction with wages and salaries. [13, 14]
• Inflexible work schedules. [10]
• Inability to build long-term relationships with clients/residents. [10]
• Caring for dying residents when there is a lack of emotional support. [9]

• Establish healthy work-life boundaries to ensure adequate rest and relaxation outside of work hours.
• Workers should communicate with supervisors about the importance of having access to necessary material resources to perform the job effectively.
• Take advantage of opportunities for skill-building, education and training provided by the organisation.

• Implement measures to minimise excessive working hours, such as scheduling rotations and providing adequate breaks. 
• Establish a supportive environment that encourages open communication and addresses concerns related to job insecurity. 
• Implement recognition and reward systems to acknowledge worker efforts and foster a sense of accomplishment.

1. Zidane YJ, Hussein BA, Gudmundsson JØ, Ekambaram A. Categorization of organizational factors and their impact on project performance. Procedia Soc Behav Sci. 2016;226:162-169.  
2. New South Wales Government. Organisational risk factors for burnout [Internet]. Sydney (AU): New South Wales Government; 2023 [cited 2024 June 13]. Available from: https://www.psc.nsw.gov.au/assets/psc/2.-Burnout-Organisational-Risk-Factors-Guide.pdf.  
3. Cao X, Naruse T. Effect of time pressure on the burnout of home‐visiting nurses: The moderating role of relational coordination with nursing managers. Jpn J Nurs Sci. 2019;16(2):221-231.  
4. Estabrooks CA, Squires JE, Carleton HL, Cummings GG, Norton PG. Who is looking after mom and dad? Unregulated workers in Canadian long-term care homes. Can J Aging. 2015;34(1):47-59.  
5. Naruse T, Taguchi A, Kuwahara Y, Nagata S, Watai I, Murashima S. Relationship between perceived time pressure during visits and burnout among home visiting nurses in Japan. Jpn J Nurs Sci. 2012;9(2):185-194.  
6. Schmidt SG, Dichter MN, Bartholomeyczik S, Hasselhorn HM. The satisfaction with the quality of dementia care and the health, burnout and work ability of nurses: A longitudinal analysis of 50 German nursing homes. Geriatr Nurs. 2014;35(1):42-46.  
7. Yeatts DE, Seckin G, Shen Y, Thompson M, Auden D, Cready CM. Burnout among direct‐care workers in nursing homes: Influences of organisational, workplace, interpersonal and personal characteristics. J. Clin. Nurs. 2018;27(19-20):3652-3665.  
8. Chamberlain SA, Hoben M, Squires JE, Cummings GG, Norton P, Estabrooks CA. Who is (still) looking after mom and dad? Few improvements in care aides’ quality-of-work life. Can J Aging. 2019;38(1):35-50.  
9. Olley R. Hear me, see me, trust you–job burnout and disengagement of Australian aged care workers. Leadersh. Health Serv. 2022;36(1):111-124.  
10. Pott K, Chan K, Leclerc A, Bernard C, Song A, Puyat J, et al. Death in long-term care: Focus groups and interviews identify strategies to alleviate staff burnout. Journal of Long-Term Care. 2020;2020:131-143.  
11. Möckli N, Denhaerynck K, De Geest S, Leppla L, Beckmann S, Hediger H, et al. The home care work environment’s relationships with work engagement and burnout: A cross‐sectional multi‐centre study in Switzerland. Health Soc. Care Community. 2020;28(6):1989-2003.  
12. Hung Y-N, Chiu T-Y. Examining the relationship between personality traits, work experience, burnout, and intention to stay among home care aides in Taiwan. BMC Geriatr. 2023;23(1):434.  
13. Kim BJ, Choi CJW. Impact of compensation and willingness to keep same career path on burnout among long-term care workers in Japan. Hum. Resour. Health. 2023;21(1):64.  
14. Hallaran AJ, Jessup SJ. Examining predictors of intention to leave in home care and differences among types of providers. J. Nurs. Manag. 2023;2023.  
15. Navarro Prados AB, Jiménez García‐Tizón S, Meléndez JC. Sense of coherence and burnout in nursing home workers during the Covid‐19 pandemic in Spain. Health Soc. Care Community. 2022;30(1):244-252.