Project Summary
Royal Freemasons’ Benevolent Institution in partnership with Macquarie University has been awarded an ARIIA grant for their project ‘Employee Burnout: Resilience and Recovery as Employee Retention Strategy in Residential Aged Care’.
This project aims to develop and implement a sustainable, multi-level, capability-building initiative in the residential aged care workforce to support managers and employees in recovering from burnout, leading to reduced employee turnover and ultimately leading to improved care for residents.
Implementation of the program's three key components will be documented for potential sector scalability: First, it will be co-designed with stakeholders with local and deep understanding of the issues in the sector. Second, in addition to the (a) resilience leadership training for managers to identify and support employee burnout and recovery over time and (b) employee burnout skills training, the project includes post-training innovative evidence-based (c) self-reflection strategies that have been proven to enhance and sustain the effectiveness of resilience training and (d) manager coaching to consolidate learnings. Last, the program is supplemented by embedded organisational practices to promote burnout identification and recovery for a healthier, more engaged, and resilient workforce.
This comprehensive approach incorporates factors that promote the long-term sustainability of employee resilience, resilience leadership, and hence reduced staff turnover. The project will improve the quality of care provided to residents, resulting in a better quality of life for both the aged care workforce and the residents they serve.
Project Outcomes
Background and Aims
The project aimed to enhance employee resilience and reduce burnout in aged care through self-reflection after tailored training programs for both staff and management, using themes found in in-depth employee interviews. The objectives included improving personal resilience and self-reflection strategies, as well as fostering a supportive workplace culture. The project sought to embed these practices into organisational systems to improve staff well-being and ultimately enhance resident care.
What We Did
We conducted a multi-phase intervention in 16 intervention and 6 control residential aged care villages in regional and metropolitan NSW, with:
- Interviews: We conducted interviews with 75 employees and managers in 15 villages to understand specific beliefs, causes and effects of burnout in this sector.
- Tailored training to the sector: We tailored novel self-reflection for resilience training presentation and workbook materials used previously in military and missionary settings to the aged care setting
- Resilience Leadership Training: In intervention villages we provided resilience leadership training to managers, including follow-up coaching to enhance their ability to support their teams' well-being.
- Employee resilience workshops: In intervention villages we conducted workshops focusing on stress and taught self-reflection for resilience strategies
- Self-reflection activities: Employees were asked to complete one 15-minute self-reflection activity each of five weeks after their resilience workshop
- Research: Under clinical trial conditions we conducted surveys before the workshops, around five weeks later and again around three months later to determine any changes in attendees’ attitudes to burnout, resilience, depression, anxiety and stress, and employee attitudes such as job satisfaction and organisational commitment
- Embedding Practices: We provided online versions of workshops and training and integrated the self-reflection practices into organisational procedures (e.g., scrums, handovers) so the self-reflection process may be sustained in the organisation.
Outcomes
- Although there were improvements in clinical outcomes between intervention and control villages (falls with major injuries down by 28%, pressure injuries down by 0.6%, infections down by 49.1%), we are cautious in attributing cause to the workshops, given potential alternative explanations.
- Comparing organisational records of HR data in the three months before and after the workshops:
- Consistent with prior research, absenteeism increased in intervention (26%) compared with control (4%) villages as employees recognised their stress, likely a temporary spike.
- Employee turnover reduced by 17% in intervention villages compared with a 30% increase in control villages. With 2000 employees, we suggest an annualised 2.6% reduction in turnover conservatively represents savings of $780,000 per annum.
- Key mental health indicators: Using employee survey data we found self-reflection significantly improved depression, stress and resilience, while workshops improved depression and anxiety:
- Key employee attitudes: We found statistically significant improvements in job satisfaction and organisational commitment in workshop attendees and those who self-reflected.
Impact on Aged Care and Workforce
We believe these results are encouraging for the aged care workforce. Statistically significant improvements in turnover, depression, anxiety, stress, job satisfaction and organisational commitment demonstrate that appropriate tailored attention on key employee issues can make a substantial difference that can improve conditions for both employees and the organisation.
Resources Developed
Leader briefings, employee workshops, workbooks and training aids are available under licence from Dr Monique Crane or Professor Denise Jepsen.
Next Steps
The researchers plan to apply for further funding to implement a slightly revised version of the self-reflection for resilience project in other aged care organisations. Organisations interested in participating should email Professor Denise Jepsen for more information. RFBI plan to use the in-person and online leader briefing and employee workshop materials to reinforce the training and interventions over the coming years.