Unseen but essential: Administrative staff burnout in health systems
While a lot of attention is focused on clinical staff pressures, those in admin positions are feeling the heat, too.
In healthcare, conversations about burnout rightly spotlight physicians and nurses. Yet, there is another cohort sustaining our systems — administrative staff — who often remain unseen despite being equally susceptible to burnout.
This article explores a recent mixed-methods study on burnout among nonclinical health system employees, revealing tensions between quantitative calm and qualitative distress, and highlighting imperative insights for leaders.
The hidden workforce under pressure
Health systems depend heavily on administrative professionals, ranging from finance and compliance to data analytics and human resources. Together, they comprise nearly half of a health system’s workforce; however, their burnout seldom receives similar scrutiny to that of clinical staff.
Our study, “Experiences of Burnout among Health Systems’ Employees,” sought to bridge that gap. Using an 18-question abbreviated Maslach Burnout Inventory (MBI) alongside 23 semi-structured interviews, we aimed to quantify burnout levels and interpret how staff interpret stressors within evolving operational landscapes.
Quantitative and qualitative disparities
Survey responses indicated that, on average, emotional exhaustion scores were low; most respondents did not report frequent feelings of fatigue or inefficacy; depersonalization was uncommon; and worklife boundaries remained largely intact.
At face value, administrative burnout appeared limited, representing a contrast to the high rates often seen among clinicians. These results may initially suggest that structural resilience and role clarity protected staff from chronic distress.
Yet, interviews revealed a more complex picture. Nearly every participant recalled moments of acute burnout, most notably during the COVID-19 pandemic.
One respondent noted that, “COVID, by far, has been the most stressful event of my career… we were meeting, literally, seven days a week, nonstop, early morning, late evening.”
One administrator even remarked, “To be honest, getting a speeding ticket would have been less stressful than what I dealt with at work.”
These narratives illuminate a pervasive undercurrent of burnout that was not fully captured by survey data, highlighting a vulnerability not reflected in quantitative metrics alone.
Why the divergence?
Three potential factors may explain this disconnect.
Survey timing. Burnout may have been episodic — peaking during crisis periods and later subsiding — while our survey captured a quieter moment.
Underreporting tendencies. Administrative staff may be reluctant to acknowledge burnout because of cultural expectations around stoicism and productivity.
Instrument limitations. The MBI, engineered primarily for clinical roles, may not fully account for experiences of burnout that are unique to administrative contexts.
This suggests a critical insight: “No news” on employee morale does not equal stability.
Leadership implications
For health system executives, these findings prompt urgent questions.
Are we listening effectively? Techniques like pulse surveys and engagement platforms have limits. Qualitative methods such as roundtable discussions and anonymous interviews can uncover deeper stressors.
Is burnout iterative or episodic? Understanding temporal patterns of distress, especially during surges, organizational shifts, or staffing bottlenecks, can help leaders pre-empt systemic breakdowns.
Do our tools reflect our people? Tailoring assessment tools to administrative work — measuring factors like workload variability, task switching and role ambiguity — can better identify hidden pain points.
This exploration marks the first in a three-part series investigating administrative burnout in health systems. Part 2 will unpack the root causes: pandemic-induced upheaval, workload proliferation and organizational volatility. Part 3 will propose evidence-based strategies that empower individuals and redefine leadership responsibilities.
ShapeAdmin staff are the connective tissue of health systems. They monitor processes, ensure compliance, manage data and, in crises, absorb the turbulence. Their burnout may not flare in surveys, but it reverberates through operations.
For those who lead health systems, turning a blind eye is no longer an option. Listening intentionally, measuring thoughtfully and acting decisively can pave the way for a workforce that sustains both itself and the broader health enterprise.
Teray Johnson, PhD, MS, MBA, FACHDM, is a director of healthcare analytics and operations. She drives organizational transformation by facilitating data-driven decisions.