Positive Leadership Within Breast Imaging: Impact on Burnout, Intent to Leave, and Engagement

Background: High rates of provider burnout and turnover, as well as staffing shortages, are creating crises within radiology departments. Identifying ways to support health care workers, such as the Positively Energizing Leadership program, is important during these ongoing crises. Purpose: To identify the relationship between leadership behaviors and workplace climate and health care worker outcomes (ie, burnout, intent to leave, and engagement) and to determine whether the positive leadership program could improve workplace climate and health care worker outcomes. Materials and Methods: This prospective study involved two parts. First, a web -based survey was administered to faculty and staff in a breast imaging unit of a large academic medical center in February 2021 to identify relationships between leadership behaviors and workplace climate and health care worker outcomes. Second, a web -based survey was administered in February 2023, following the implementation of a positive leadership program, to determine improvement in engagement and reduction of burnout and intent to leave since 2021. Multiple regression, the Sobel test, Pearson correlation, and the t test were used, with a conservative significance level of P < .001. Results: The sample consisted of 88 respondents (response rate, 95%) in 2021 and 85 respondents (response rate, 92%) in 2023. Leadership communication was associated with a positive workplace climate ((3 = 0.76, P < .001) and a positive workplace climate was associated with improved engagement ((3 = 0.53, P < .001), reduction in burnout ((3 = -0.42, P < .001), and reduction in intent to leave ((3 = -0.49, P < .001). Following a 2 -year positive leadership program, improved perceptions were observed for leadership communication (pretest mean, 4.59 +/- 1.51 [SD]; posttest mean, 5.80 +/- 1.01; t = 5.97, P < .001), workplace climate (pretest mean, 5.09 +/- 1.43; posttest mean, 5.77 +/- 1.11; t = 3.35, P < .001), and engagement (pretest mean, 5.27 +/- 1.20, posttest mean, 5.68 +/- 0.96; t = 2.50, P < .01), with a reduction in burnout (pretest mean, 2.69 +/- 0.94; posttest mean, 2.18 +/- 0.74; t = 3.50, P < .001) and intent to leave (pretest mean, 3.12 +/- 2.23; posttest mean, 2.56 +/- 1.84; t = 1.78, P < .05). Conclusion: After implementation of a positive leadership program in a radiology department breast imaging unit, burnout and intention to leave decreased among health care workers, while engagement increased.