Leadership Best Practices for Improving Engagement and Burnout in Health Facilities: A Positive Deviance Approach From the Veterans Health Administration

In health care settings, employee engagement and burnout vary widely. Little is known, however, about how leadership actions may influence this variation. This study identified leadership behaviors that may increase employee engagement and decrease staff burnout in the Veterans Health Administration (VHA). Applying a positive deviance approach to examine organizational survey data across the entire administration, we first statistically identified VHA sites that, based on employee feedback, showed the greatest improvement in engagement or burnout from 2021 to 2022. We then interviewed these sites' directors (N = 15) or primary care service chiefs (N = 13) about how they achieved this. Findings indicate commonalities across these leaders' best practices. Interviewees emphasized creating community, making providers feel valued, including staff to assess and optimize organizational efficiency, and strategically communicating to obtain feedback and share updates. These findings highlight skills and attention foci of health care leaders relevant to increasing engagement and decreasing burnout.