Healthcare leader perspectives on strategies to implement and sustain interventions that promote employee wellbeing and reduce burnout.

backgroundBurnout and psychological distress among healthcare professionals are associated with adverse patient outcomes, workforce turnover, and substantial costs to health systems. Although a range of wellbeing interventions have demonstrated effectiveness, healthcare organizations continue to face challenges in implementing and sustaining these programs at the organizational level. Understanding leadership perspectives on implementation is critical to informing effective, system-level approaches to clinician wellbeing.

methodsWe conducted a qualitative study using semi-structured interviews with senior healthcare leaders across the United States, including Chief Wellness Officers, Chief Medical Officers, and senior nursing leaders. Participants were purposively sampled to represent diverse health systems and professional roles. Interviews were conducted between March and November 2024, audio recorded, professionally transcribed, and analyzed using thematic analysis. An iterative coding process was employed, with investigator triangulation used to enhance trustworthiness.

resultsTwenty-one healthcare leaders participated in the study. Four interrelated themes were identified: (1) professional wellbeing was viewed as fundamentally dependent on organizational and structural drivers rather than individual-level wellness efforts alone; (2) visible leadership presence and frontline engagement were perceived as critical to the credibility and effectiveness of wellbeing initiatives; (3) implementation required ongoing navigation of tensions between heterogeneous individual clinician needs and organizational constraints; and (4) sustaining wellbeing initiatives depended on framing them in ways that aligned with institutional priorities, often through a business case emphasizing retention, cost, and quality of care. Leaders consistently noted that symbolic or individual-focused interventions were insufficient without addressing workload, staffing, and operational inefficiencies.

conclusionsSenior healthcare leaders view clinician wellbeing as a shared organizational responsibility requiring structural change, leadership engagement, and strategic alignment. Effective implementation of wellbeing initiatives depends on integrating interventions into existing workflows, addressing systemic barriers, and articulating their value in organizational terms. These findings underscore the importance of systems-based approaches to sustaining clinician wellbeing within complex healthcare environments. CLINICAL TRIAL NUMBER: Not applicable.