HEALTHCARE WORKER WELLBEING: 

Making the 

System Work for 

Healthcare Workers

BURNOUT IS REAL—ADDRESSING IT SO HEALTHCARE WORKERS CAN THRIVE 

GOES BEYOND OFFERING INDIVIDUAL SUPPORT RESOURCES. 

From how a hospital is staffed to timeconsuming clicks in electronic health records, 

processes and policies can affect a hospital’s 

ability to create a safe, healthy environment for 

its workforce. How hospital leaders run their 

departments directly impacts their ability to 

have a strong workplace culture, cultivate an 

engaged workforce, and deliver high-quality, 

safe patient care. 

Addressing workplace policies 

and practices is the best way 

to reduce burnout and support 

healthcare workers’ wellbeing. 

Additionally, it optimizes patient 

outcomes and addresses costs 

associated with staff turnover, 

lost revenue, and threats to a 

hospital’s long-term viability.i

MOVING BEYOND 

INDIVIDUAL RESILIENCE 

While many hospitals have made strides to 

address healthcare workers’ wellbeing, it is 

critical to go beyond encouraging self-care.ii

Hospitals need support as they adjust and 

create systems that sustain worker wellbeing.

For more than 50 years, the National Institute 

for Occupational Safety and Health (NIOSH) 

has empowered employers, including hospital 

leaders, with the strategies and resources critical 

to creating sustainable, safe workplaces. That is 

why NIOSH and its partners are at the forefront 

of working with hospital leaders on developing 

and implementing customized, hospital-specific 

solutions to reduce healthcare worker burnout.

This fall, NIOSH is:

• Launching a national campaign with free, 

evidence-informed resources to help 

hospital leaders:

– Think differently about how to maximize 

existing resources, 

– Fine-tune current processes, and 

– Establish new policies at their hospital 

that include wellbeing as a key 

performance indicator.

• Developing an actionable guide, tested 

in real-world settings, to help hospital 

leaders implement systems-level changes, 

from revising existing processes to making 

it safe for staff to access mental health care.
LAYING THE GROUNDWORK

One of the most substantial systems barriers to 

healthcare worker wellbeing is intrusive mental 

health questions on hospital credentialing 

applications.iii,v Healthcare workers fear losing 

their credentials because of overly broad 

and invasive mental health questions that are 

stigmatizing and discriminatory.iv 

Nearly 4 in 10 physicians were 

either afraid or knew another 

physician fearful of seeking mental 

health care because of questions 

asked in licensure, credentialing, 

or insurance applications.v

Like everyone, healthcare workers deserve the 

right to pursue the mental health care they may 

need, without fear of losing their job. In fact, The 

Joint Commission does not require organizations 

to ask about a worker’s mental health history and 

encourages them to not do so.vi The Federation 

of State Medical Boards also recommends 

against such questions on credentialing forms.vii

START NOW WITH TOOLS FROM THE DR. LORNA BREEN 

HEROES’ FOUNDATION 

The Dr. Lorna Breen Heroes’ Foundation developed three simple steps hospital leaders can follow 

to remove this barrier and make it safe for their healthcare workers to seek the care they may need. 

AUDIT

all credentialing applications, 

addendums, and peer 

review forms.

CHANGE

any invasive or 

stigmatizing language 

around mental health.

COMMUNICATE

these changes back to the 

workers and assure healthcare 

workers that it is safe for 

them to seek care.

BECOMING A WELLBEING FIRST CHAMPION FOR CREDENTIALING, SPONSORED BY 

ALL IN: WELLBEING FIRST FOR HEALTHCARE 

ALL IN: WellBeing First for Healthcare, an independent coalition of healthcare organizations led by the 

Dr. Lorna Breen Heroes’ Foundation, is recognizing hospitals for taking these three steps to remove intrusive 

mental health questions from credentialing applications. To become a WellBeing First Champion for 

Credentialing by September, submit your credentialing applications to the ALL IN coalition for verification.
Removing intrusive questions on 

credentialing applications is a critical step 

to supporting healthcare worker wellbeing, 

but it is not the only one. Systems change 

for improved healthcare worker wellbeing 

is an ongoing effort. As hospital leaders 

expand on these initiatives, NIOSH looks 

forward to providing the needed resources 

to make every hospital a safe, healthy, and 

sustainable workplace for all. 

To receive updates and resources from NIOSH’s upcoming 

healthcare worker wellbeing campaign, sign up for the 

Total Worker Health® mailing list here.

i. National Academies of Sciences, Engineering, and Medicine [2019]. Taking action against clinician burnout: A systems approach to 

professional well-being. Washington, DC: The National Academies Press, https://doi.org/10.17226/25521.

ii. American Hospital Association [2021]. AHA Hospitals in Action: Supporting Care Teams. Washington, DC: American Hospital Association, 

https://www.aha.org/system/files/media/file/2021/03/lln-playbook-companion-0321.pdf

iii. Weston MJ, Nordberg A [2022]. Stigma: A barrier in supporting nurse well-being during the pandemic. Nurse Lead 20(2):174-178. doi: 

10.1016/j.mnl.2021.10.008. 

iv. Jones J, North C, Vogel-Scibilia S, Myers M, Owen R [2018]. Medical licensure questions about mental illness and compliance with the 

Americans with Disabilities Act. J Am Acad Psychiatry Law 46(4):458-471. https://jaapl.org/content/46/4/458 

v. The Physicians Foundation [2022]. 2022 survey of America’s physicians: Part two of three: Understanding the state of physicians’ wellbeing 

and assessing solutions to address it. Boston, MA: The Physicians Foundation, https://physiciansfoundation.org/physician-and-patientsurveys/the-physicians-foundation-2022-physician-survey-part-2/.

vi. The Joint Commission [2020]. Joint commission statement on removing barriers to mental health care for clinicians and health care staff. 

Oakbrook Terrace, IL: The Joint Commission, https://www.jointcommission.org/-/media/tjc/documents/covid19/statement-on-removingbarriers-to-mental-health-care-for-clinicians-and-health-care-staff.pdf. 

vii. Federation of State Medical Boards [2018] Physician wellness and burnout. Washington, DC: Federation of State Medical Boards. 

https://www.fsmb.org/siteassets/advocacy/policies/policy-on-wellness-and-burnout.pdf.

DHHS (NIOSH) Publication No. 2023-136

DOI: https://doi.org/10.26616/NIOSHPUB2023136

May 2023