Assessing the predictive influence of organizational culture on employee burnout within health systems: Insights and strategic implications

Organizational culture (OC) affects every workplace, yet few studies have explored the relationship between OC and burnout using machine learning methods, which could provide new insights. This exploratory study employed a random forest algorithm to examine the relationship between OC and burnout among employees in health systems, aiming to determine whether OC can predict employee burnout. A 57-question survey assessing perceptions of OC and burnout was administered to employees across various health systems in the United States, yielding 67 responses. These survey results were used to train and test the random forest model. The findings indicated that several aspects of OC, such as job interference with home life, are predictive of burnout. Based on these preliminary results, employers should be aware of their organization’s culture and actively work to improve it to alleviate employee burnout. Leaders should implement strategies, such as allowing flexible work schedules to promote work-life balance and providing employees with the necessary resources to excel in their roles. The model also highlights the significant impact of OC on burnout, suggesting that a variety of burnout symptoms may signal the need for improvements in OC. This study serves as a starting point for future research to further explore how OC predicts burnout, while emphasizing the importance of cultivating a positive OC.
- Schein EH. Organizational Culture and Leadership. San Francisco: Jossey-Bass Publishers; 2010.
- Hofstede G. Culture’s Consequences: Comparing Values, Behaviors, Institutions and Organizations Across Nations. 2nd ed. Thousand Oaks: Sage; 2001.
- Maslach C, Leiter MP. Burnout. In: Stress: Concepts, Cognition, Emotion, and Behavior. Netherlands: Elsevier; 2016. p. 351-357. doi: 10.1016/B978-0-12-800951-2.00044-3
- Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career Dev Int. 2009;14(3):204-220. doi: 10.1108/13620430910966406
- Tawfik DS, Scheid A, Profit J, et al. Evidence relating health care provider burnout and quality of care. Ann Intern Med. 2019;171(8):555. doi: 10.7326/M19-1152
- Cameron K, Quinn R. Diagnosing and Changing Organizational Culture: Based on the Competing Values Framework. 3rd ed. United States: John Wiley & Sons; 2011.
- Schaufeli WB, Bakker AB. Job demands, job resources, and their relationship with burnout and engagement: A multi‐sample study. J Organ Behav. 2004;25(3):293-315. doi: 10.1002/job.248
- Maslach C, Leiter MP. Early predictors of job burnout and engagement. J Appl Psychol. 2008;93(3):498-512. doi: 10.1037/0021-9010.93.3.498
- Alarcon GM. A meta-analysis of burnout with job demands, resources, and attitudes. J Vocat Behav. 2011;79(2):549-562. doi: 10.1016/j.jvb.2011.03.007
- Chatterjee S, Goyal D, Prakash A, Sharma J. Exploring healthcare/health-product ecommerce satisfaction: A text mining and machine learning application. J Bus Res. 2021;131:815-825. doi: 10.1016/j.jbusres.2020.10.043
- Bhardwaj S, Bhardwaj H, Bhardwaj J, Gupta P. Global prediction of COVID-19 Cases and Deaths using Machine Learning. In: 2021 Sixth International Conference on Image Information Processing (ICIIP). IEEE; 2021. p. 422-426. doi: 10.1109/ICIIP53038.2021.9702560
- Ang CY, Lee MH, Paramesran R. A survey of machine learning techniques for behavioral data analysis on mobile devices. Inform Fusion. 2020;49:46-60.
- Shatte ABR, Hutchinson DM, Teague SJ. Machine learning in mental health: A scoping review of methods and applications. Psychol Med. 2019;49(9):1426-1448. doi: 10.1017/S0033291719000151
- Podsakoff PM, MacKenzie SB, Lee JY, Podsakoff NP. Common method biases in behavioral research: A critical review of the literature and recommended remedies. J Appl Psychol. 2003;88(5):879-903. doi: 10.1037/0021-9010.88.5.879
- DeVellis RF, Thorpe CT. Scale Development: Theory and Applications. 5th ed. United States: SAGE Publications; 2022.
- Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi: 10.1191/1478088706qp063oa
- Bakker AB, Demerouti E. The Job Demands‐Resources model: State of the art. J Manag Psychol. 2007;22(3):309-328. doi: 10.1108/02683940710733115
- Dewa CS, Loong D, Bonato S, Thanh NX, Jacobs P. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res. 2014;14(1):325. doi: 10.1186/1472-6963-14-325
- Sonnentag S, Frese M. Stress in organizations. In: Borman WC, Ilgen DR, Kilmoski RJ, editors. Comprehensive Handbook of Psychology. Vol. 12. United States: Wiley; 2003. p. 454-481.
- Oei MW, Pasinringi SA, Sidin AI, Noor NB, Rivai F, Healty. The influence of organizational culture and group climate on innovation readiness at Hasanuddin university hospital. Pharmacogn J. 2024;16(1):150-155. doi: 10.5530/pj.2024.16.21
- Lee T, Yoon YS, Ji Y. Predicting new graduate nurses’ retention during transition using decision tree methods: A longitudinal study. J Nurs Manag. 2024;2024:1-11. doi: 10.1155/2024/4687000
- Louhenapessy EL, Lindawati T. Effect of emotional intelligence and organizational culture on performance with organizational commitment as mediation. Eduvest J. Univ. Stud. 2022;2(3):554-570. doi: 10.36418/edv.v2i3.384
- Tavella G, Spoelma M, Parker G. Detecting burnout: Identifying key symptoms using standard and machine learning methods. Int J Stress Manag. 2023;30(4):366-375. doi: 10.1037/STR0000296
- Grządzielewska M. Using machine learning in burnout prediction: A survey. Child Adolesc Soc Work J. 2021;38(2):175-180. doi: 10.1007/s10560-020-00733-w
- Taylor S, Jaques N, Nosakhare E, Sano A, Picard R. Personalized multitask learning for predicting tomorrow’s mood, stress, and health. IEEE Trans Affect Comput. 2020;11(2):200-213. doi: 10.1109/TAFFC.2017.2784832
- Bauernhofer K, Bassa D, Canazei M, et al. Subtypes in clinical burnout patients enrolled in an employee rehabilitation program: Differences in burnout profiles, depression, and recovery/resources-stress balance. BMC Psychiatry. 2018;18(1):10. doi: 10.1186/s12888-018-1589-y
- Lee YL, Chou W, Chien TW, Chou PH, Yeh YT, Lee HF. An app developed for detecting nurse burnouts using the convolutional neural networks in microsoft excel: Population-based questionnaire study. JMIR Med Inform. 2020;8(5):e16528. doi: 10.2196/16528
- Park J, Feng Y, Jeong SP. Developing an advanced prediction model for new employee turnover intention utilizing machine learning techniques. Sci Rep. 2024;14(1):1221. doi: 10.1038/s41598-023-50593-4
- del Pozo-Antúnez JJ, Molina-Sánchez H, Ariza-Montes A, Fernández-Navarro F. Promoting work engagement in the accounting profession: A machine learning approach. Soc Indic Res. 2021;157(2):653-670. doi: 10.1007/s11205-021-02665-z
- Schaufeli WB, Salanova M, González-romá V, Bakker AB. The measurement of engagement and burnout: A two sample confirmatory factor analytic approach. J Happiness Stud. 2002;3(1):71-92. doi: 10.1023/A:1015630930326
- Bailey C, Madden A, Alfes K, Fletcher L. The meaning, antecedents and outcomes of employee engagement: A narrative synthesis. Int J Manage Rev. 2017;19(1):31-53. doi: 10.1111/ijmr.12077
- Johnson T, Shamroukh S. Predictive modeling of burnout based on organizational culture perceptions among health systems employees: A comparative study using correlation, decision tree, and Bayesian analyses. Sci Rep. 2024;14(1):6083. doi: 10.1038/s41598-024-56771-2
- Kovner CT, Brewer CS, Fatehi F, Katigbak C. Changing trends in newly licensed RNs. Am J Nurs. 2014;114(2):26-34; quiz 35. doi: 10.1097/01.NAJ.0000443767.20011.7f
- Kovner CT, Brewer CS, Fairchild S, Poornima S, Kim H, Djukic M. Newly licensed RNs’ characteristics, work attitudes, and intentions to work. Am J Nurs. 2007;107(9):58-70. doi: 10.1097/01.NAJ.0000287512.31006.66
- Havaei F, Ji XR, MacPhee M, Straight H. Identifying the most important workplace factors in predicting nurse mental health using machine learning techniques. BMC Nurs. 2021;20(1):216. doi: 10.1186/S12912-021-00742-9
- Lee MCC, Ding AYL. The relationship between market culture, clan culture, benevolent leadership, work engagement, and job performance: Leader’s dark triad as a moderator. Psychol Rep. 2024;127(2):887-911. doi: 10.1177/00332941221121564
- Roth C, Berger S, Krug K, Mahler C, Wensing M. Internationally trained nurses and host nurses’ perceptions of safety culture, work-life-balance, burnout, and job demand during workplace integration: A cross-sectional study. BMC Nurs. 2021;20(1):77. doi: 10.1186/s12912-021-00581-8
- Sun JW, Franklin JM, Rough K, et al. Predicting overdose among individuals prescribed opioids using routinely collected healthcare utilization data. PLoS One. 2020;15(10):e0241083. doi: 10.1371/JOURNAL.PONE.0241083
- Lee E, Jang I. Nurses’ fatigue, job stress, organizational culture, and turnover intention: A culture-work-health model. West J Nurs Res. 2020;42(2):108-116. doi: 10.1177/0193945919839189
- Yildizoğlu H, Cemaloğlu N. Examination of the relationship between teachers’ organizational change fatigue levels and the organizational resilience levels of secondary education institutions. Kastamonu Eğitim Derg. 2023:186-201. doi: 10.24106/KEFDERGI.1271471
- Leiter M, Maslach C. The Truth About Burnout: How Organizations Cause Personal Stress and What to.- Christina Maslach, Michael P. Leiter-Google Books. 1st ed. Jossey-Bass; 1997. Available from: https://books. googl e.com/books?hl=en&lr=&id=uzomWhbqc CAC&oi=fnd&pg=PR7&dq=the+truth+about+burnout+ how+organizations+cause+personal+stress&ots=9B9sq oSFTB&sig=L4MGTLfkwsYzLRc4Jj4TZXr-cak#v=onepage &q=the%20truth%20about%20burnout%20how%20 organizations%20cause%20personal%20stress&f=false [Last accessed on 2022 Jun 28].
- Montgomery A, Todorova I, Baban A, Panagopoulou E. Improving quality and safety in the hospital: The link between organizational culture, burnout, and quality of care. Br J Health Psychol. 2013;18(3):656-662. doi: 10.1111/bjhp.12045
- Maslach C. Understanding burnout: Definitional issues in analyzing a complex phenomenon. In: Job Stress and Burnout. Sage; 1982. p. 29-40. Available from: https:// scholar.google.com/scholar?hl=en&as_sdt=0%2C31&q= Und e r s t and i ng + bu r nout%3A+De f i n i t i ona l +issues+in+analyzing+a+complex+phenomenon.+InJob+ Stress+and+Burnout&btnG= [Last accessed on 2022 Jun 28].
- Maslach C, Leiter M. Burnout and engagement in the workplace: A contextual analysis. Adv Motivat Achiev. 1999;11:275-302.
- Gardner JK, Thomas-Hawkins C, Fogg L, Latham CE. The relationships between nurses’ perceptions of the hemodialysis unit work environment and nurse turnover, patient satisfaction, and hospitalizations. Nephrol Nurs J. 2007;34:271-281.
- Wright ES. The effects of organizational culture on employee turnover. Perform Improv Q. 2021;34(3):303-319. doi: 10.1002/PIQ.21372
- Lee MS, Lee BS, Kim TK, Lee JY. The factors affecting the turnover intention of nurses at a hospital. Indian J Public Health Res Dev. 2018;9(3):539-544. doi: 10.5958/0976-5506.2018.00346.7
- Lim S, Shin S. Moderating effect of nursing organizational culture on the relationship between verbal violence and burnout in operating room nurses. Korean J Adult Nurs. 2022;34(2):196. doi: 10.7475/kjan.2022.34.2.196
- Lopes MCC, Oliva CCC, Bezerra NMS, Silva MT, Galvão TF. Relationship between depressive symptoms, burnout, job satisfaction and patient safety culture among workers at a university hospital in the Brazilian Amazon region: Cross-sectional study with structural equation modeling. Sao Paulo Med J. 2022;140(3):412-421. doi: 10.1590/1516-3180.2021.0614.15092021
- de Lima Garcia C, Bezerra IMP, Ramos JLS, do Valle JETMR, de Oliveira MLB, de Abreu LC. Association between culture of patient safety and burnout in pediatric hospitals. PLoS One. 2019;14(6):e0218756. doi: 10.1371/journal.pone.0218756
- Williams ES, Manwell LB, Konrad TR, Linzer M. The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: Results from the MEMO study. Health Care Manage Rev. 2007;32(3):203-212. doi: 10.1097/01.HMR.0000281626.28363.59
- Hossny EK, Morsy SM, Ahmed AM, Saleh MSM, Alenezi A, Sorour MS. Management of the COVID-19 pandemic: Challenges, practices, and organizational support. BMC Nurs. 2022;21(1):196. doi: 10.1186/S12912-022-00972-5
- Konlan KD, Asampong E, Dako-Gyeke P, Glozah FN. Burnout and allostatic load among health workers engaged in human resourced-constrained hospitals in Accra, Ghana. BMC Health Serv Res. 2022;22(1):1163. doi: 10.1186/S12913-022-08539-5
- Patterson PB, Mumtaz Z, Chirwa E, Mambulasa J, Kachale F, Nyagero J. Culture’s place in quality of care in a resource-constrained health system: Comparison between three Malawi districts. Qual Health Res. 2021;31(13):2528-2541. doi: 10.1177/10497323211037636
- Welp A, Meier LL, Manser T. Emotional exhaustion and workload predict clinician-rated and objective patient safety. Front Psychol. 2015;5:1573. doi: 10.3389/fpsyg.2014.01573
- Kepplinger A, Braun A, Fringer A, Roes M. Opportunities for nurses to address employee voice in health care providers: A scoping review. BMC Nurs. 2024;23(1):651. doi: 10.1186/s12912-024-02331-y
- Pamungkas W. Determining employee job satisfaction and work productivity: An analysis of HR competency and organizational culture at PT. XYZ. Dinasti Int J Manage Sci. 2024;5(5):1017-1026.
- Gill-Bonanca K. Mentorship: A strategy for nursing retention. Am Nurse J. 2024;19(8):6-12. doi: 10.51256/ANJ082406
- Reddy S, Sai P. Impact of hybrid work model on employee engagement and productivity. Amity Bus Rev. 2024;25(1):42-51.
- Lee SE, Shin G. The effect of perceived organizational and supervisory support on employee engagement during COVID-19 crises: Mediating effect of work-life balance policy. Public Pers Manage. 2023;52(3):401-428. doi: 10.1177/00910260231171395
- Melnyk BM, Davidson JE, Mayfield C, et al. A study protocol for the modified interactive screening program plus MINDBODYSTRONG© RCT: A mental health resiliency intervention for nurses. PLoS One. 2024;19(6):e0303425. doi: 10.1371/journal.pone.0303425
- Virani T, Ismail F, Brooke J. Beyond traditional practices: Innovating workplace mental health in the community. Healthc Q. 2024;27(3):28-33. doi: 10.12927/hcq.2024.27444
- Maloney LM, Hoffman J, Peralta E, et al. Informal peer support and intentional acts of kindness may attenuate the impact of work-related stressors on compassion satisfaction, secondary traumatic stress, and burnout of emergency medical services clinicians. Air Med J. 2024;43(4):333-339. doi: 10.1016/j.amj.2024.03.005
- Jensen B. South Dakota physician well-being program starts peer-support groups: Social gatherings combat burnout and improve resiliency. S D Med. 2023;76(3):138-139.
- Alam F, Danieli M, Riccardi G. Annotating and modeling empathy in spoken conversations. Comput Speech Lang. 2018;50:40-61. doi: 10.1016/j.csl.2017.12.003