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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Manifesting change: an organisation’s approach to burnout, recruitment, and retention of junior doctors in Western Australia

Katie McLeod A * , Deepan Krishnasivam A and George Eskander B
+ Author Affiliations
- Author Affiliations

A Clinical Services Division, Sir Charles Gairdner Osborne Park Health Care Group, North Metropolitan Health Service, WA, Australia.

B Department of Health, WA, Australia.

* Correspondence to: mcleod.katie@protonmail.com

Australian Health Review 49, AH24053 https://doi.org/10.1071/AH24053
Submitted: 23 February 2024  Accepted: 28 January 2025  Published: 18 February 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Facing unprecedented levels of junior medical officer (JMO) vacancies, absenteeism, and burnout, the Sir Charles Gairdner Osborne Park Health Care Group (SCGOPHCG) collaborated with JMOs to create and implement the JMO Manifesto in January of 2023. With the aim of improving the organisation’s attraction, recruitment, and retention of JMOs, this initiative consisted of five strategic imperatives that addressed key workplace issues affecting JMOs: (1) part-time work opportunities, (2) access to leave and (3) overtime pay, (4) limited support for workplace issues (particularly after-hours), and (5) poor workplace culture and bullying. Led by the Clinical Services team, the JMO Manifesto was an investment in building JMO wellbeing, trust, and engagement with simple but innovative strategies. The effectiveness of these strategies was evaluated by comparing pre- and post-JMO Manifesto results from routinely collected organisational data (e.g. vacancy rates) and JMO feedback through the annual Hospital Health Check survey by the Australian Medical Association. Within 6 months, the SCGOPHCG was fully recruited, had created 35 new part-time positions and new processes for managing leave, overtime claims, and support for JMOs. Eighteen months in, we remain the top-ranking public health service provider for access to leave, claiming of un-rostered overtime, workplace culture and morale, and wellbeing support for JMOs in Western Australia. The JMO Manifesto highlights the importance of healthcare organisations investing in the engagement and wellbeing of their junior doctors to achieve a sustainable medical workforce.

Keywords: burnout, engagement, junior doctors, junior medical officer, leadership, recruitment, retention, wellbeing, workforce.

References

Low ZX, Yeo KA, Sharma VK, Leung GK, McIntyre RS, Guerrero A, Lu B, Sin Fai Lam CC, et al. Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis. Int J Environ Res Public Health 2019; 16(9): 1479.
| Crossref | Google Scholar | PubMed |

Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, West CP. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clin Proc 2015; 90(12): 1600-1613.
| Crossref | Google Scholar | PubMed |

Shanafelt TD, Noseworthy JH. Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clin Proc 2017; 92(1): 129-146.
| Crossref | Google Scholar | PubMed |

Swensen S, Kabcenell A, Shanafelt T. Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience. J Healthc Manag 2016; 61(2): 105-127.
| Google Scholar | PubMed |

Australian Medical Association. AMA Position Statement: Health and Wellbeing of Doctors and Medical Students 2020. Canberra: AMA; 2020. Available at https://www.ama.com.au/sites/default/files/documents/AMA_PS_Health_and_wellbeing_of_doctors_16_7_20.pdf [viewed November 2024].

Scott A. ANZ – Melbourne Institute Health Sector Report: The future of the medical workforce. Melbourne: Melbourne Institute of Applied Economic & Social Research, The University of Melbourne; 2019. Available at https://melbourneinstitute.unimelb.edu.au/__data/assets/pdf_file/0008/3069548/ANZ-MI-Health-Sector-Report-Future.pdf [viewed November 2024].

Australasian College for Emergency Medicine. Doctor shortages in emergency departments set to worsen in 2023. Melbourne; 2023. Available at https://acem.org.au/News/January-2023/Doctor-shortages-in-emergency-departments-set-to-w#:~:text=An%20informal%20member%20survey%2C%20conducted,for%20specialist%20trainee%20roles%2C%2030 [viewed September 2024].

Australian Salaried Medical Officers’ Federation Victoria. Working Conditions of Junior Doctors in Victoria. Melbourne: ASMOF [Victoria Branch]; 2024. Available at https://amavic.com.au/article/working-conditions-of-junior-doctors-in-victoria-report [viewed September 2024].

Willis K, Ezer P, Lewis S, Bismark M, Smallwood N. Covid Just Amplified the Cracks of the System: Working as a Frontline Health Worker during the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18(19): 10178.
| Crossref | Google Scholar | PubMed |

10  Hunter R, Willis K, Smallwood N. The workplace and psychosocial experiences of Australian junior doctors during the COVID-19 pandemic. Intern Med J 2022; 52(5): 745-754.
| Crossref | Google Scholar | PubMed |

11  Australian Medical Association Western Australia. Hospital Health Check 2022. Perth: AMA WA; 2022. Available at https://www.amawa.com.au/wp-content/uploads/2022/10/Hospital-Health-Check_2022_Full.pdf [viewed October 2023].

12  Medical Board of Australia, Australian Health Practitioner Regulation Agency. Medical Training Survey 2022. Melbourne: AHPRA; 2023. Available at https://www.medicaltrainingsurvey.gov.au/Results/Reports-and-results [viewed October 2023].

13  Lock FK, Carrieri D. Factors affecting the UK junior doctor workforce retention crisis: an integrative review. BMJ Open 2022; 12(3): e059397.
| Crossref | Google Scholar | PubMed |

14  Kotter JP. Leading Change. Boston: Harvard Business Review Press; 2012.

15  Ananda-Rajah MR, Veness BG, Berkovic D, Parker C, Kelly G, Ayton D. Hearing the voices of Australian healthcare workers during the COVID-19 pandemic. BMJ Leader 2021; 5(1): 31-35.
| Crossref | Google Scholar |

16  Berwick DM. Improvement, trust, and the healthcare workforce. Qual Saf Health Care 2003; 12(6): 448-452.
| Crossref | Google Scholar | PubMed |

17  Smallwood N, Bismark M, Willis K. Burn-out in the health workforce during the COVID-19 pandemic: opportunities for workplace and leadership approaches to improve well-being. BMJ Lead 2023; 7(3): 178-181.
| Crossref | Google Scholar | PubMed |

18  Shanafelt T, Trockel M, Rodriguez A, Logan D. Wellness-Centered Leadership: Equipping Health Care Leaders to Cultivate Physician Well-Being and Professional Fulfillment. Acad Med 2021; 96(5): 641-651.
| Crossref | Google Scholar | PubMed |

19  Australian Medical Association Western Australia. Hospital Health Check 2023. Perth: AMA WA; 2023. Available at https://www.amawa.com.au/wp-content/uploads/2023/06/Hospital-Health-Check-2023-Report.pdf [viewed October 2023].

20  Australian Medical Association Western Australia. Hospital Health Check 2024. Perth: AMA WA; 2024. Available at https://www.amawa.com.au/wp-content/uploads/2024/05/AMA-WA-2024-HHC-Report.pdf [viewed September 2024].

21  Canterino F, Cirella S, Piccoli B, Shani ABR. Leadership and change mobilization: The mediating role of distributed leadership. J Bus Res 2020; 108: 42-51.
| Crossref | Google Scholar |

22  Swensen SJ, Dilling JA, Mc Carty PM, Bolton JW, Harper CM, Jr. The business case for health-care quality improvement. J Patient Saf 2013; 9(1): 44-52.
| Crossref | Google Scholar | PubMed |

23  Health Workforce Australia. Australia’s Future Health Workforce – Nurses Detailed Report. Canberra: Department of Health and Aged Care; 2014. Available at https://www.health.gov.au/sites/default/files/documents/2021/03/nurses-australia-s-future-health-workforce-reports-detailed-report.pdf [viewed October 2023].

24  Bradford N, Moore E, Taylor K, Cook O, Gent L, Beane T, Williams N, Alexander K, et al. The cancer nursing workforce in Australia: a national survey exploring determinants of job satisfaction. BMC Nurs 2023; 22(1): 461.
| Crossref | Google Scholar | PubMed |

25  Cosgrave C, Malatzky C, Gillespie J. Social Determinants of Rural Health Workforce Retention: A Scoping Review. Int J Environ Res Public Health 2019; 16(3): 314.
| Crossref | Google Scholar | PubMed |

26  Clare J. Issues paper: teacher workforce shortages. Canberra: Department of Education; 2022. Available at https://ministers.education.gov.au/sites/default/files/documents/Teacher%20Workforce%20Shortages%20-%20Issues%20paper.pdf [viewed October 2023].