Evidence-Based Quality Improvement to Reduce VA Primary Care Burnout

NCT07031245 | Recruiting

• 2 other identifiers: CDA 21-158IK2HX003534
• Study Type: interventional
• Target: 203
• Locations: 1 country
• Sites: 5

Brief Summary

Burnout is highly prevalent among VA primary care providers and staff, impairing productivity and retention, as well as safety, quality, and patient experience. In this pilot trial, the investigators will facilitate the development of burnout reduction interventions using an evidence-based quality improvement (EBQI) approach, and then evaluate the feasibility, acceptability and effectiveness of a pilot EBQI-facilitated burnout reduction intervention in a modified stepped wedge design in one VA region.

Conditions

Burnout; Burnout Syndrome

Keywords

primary care; VA; burnout; EBQI; evidence-based; quality improvement

Outcome Measures

Primary Outcomes (1)

• Burnout

  22-item Maslach Burnout Inventory. Minimum score of 0 for all domains. Maximum score of 54 for emotional exhaustion domain. Maximum score of 30 for depersonalization domain. Maximum score of 48 for personal accomplishment domain. Higher scores are worse, except for the personal accomplishment domain where higher scores are better.

  Annually, from enrollment until the end of the study, three years later (4 survey administrations).

Secondary Outcomes (4)

• Turnover intent

  Annually, from enrollment until the end of the study, three years later (4 survey administrations).

• Workplace drivers of burnout

  Annually, from enrollment until the end of the study, three years later (4 survey administrations)

• Depression

  Annually, from enrollment until the end of the study, three years later (4 survey administrations)

• Anxiety

  Annually, from enrollment until the end of the study, three years later (4 survey administrations)

Study Arms (2)

Evidence-based quality improvement (EBQI)

EXPERIMENTAL

Evidence-based quality improvement (EBQI) to facilitate the development and implementation of one or more burnout reduction interventions. The EBQI-facilitated interventions will be actively managed my the research team for one year, and may be passively continue by clinic leadership, providers, and staff for the following years.

Behavioral: Evidence-based quality improvement (EBQI)

Usual care

NO INTERVENTION

Researchers will have no interaction with the clinics beyond survey administration.

Interventions

Evidence-based quality improvement (EBQI) BEHAVIORAL

Evidence-based quality improvement (EBQI) is a multi-level implementation strategy that aids in the development and implementation of evidence-based interventions to reduce burnout. Preliminary survey, interview, and systematic review data on burnout, turnover intent, burnout drivers, and burnout interventions will be presented to an expert panel for each intervention site. These panels will collectively decide on the top categories of burnout drivers to target and burnout interventions to implement. These top drivers and intervention categories will be presented to site-level providers and staff and proposals will be solicited for quality improvement (QI) interventions to reduce burnout that reflect these categories and address these drivers. The expert panels will then choose one or more of these QI interventions to implement and evaluate at each intervention site.

Evidence-based quality improvement (EBQI)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• primary care clinics (2 VA Medical Centers \[VAMCs\] and 3 community-based outpatient clinics \[CBOCs\]) in 2 VA healthcare systems in 1 VA Veterans Integrated Service Network
• Primary care providers, registered nurses, clinical associates (e.g., licensed vocational or practical nurses), or administrative associates (e.g., clerks) on regular Patient-Aligned Care Team (PACT) teamlets at a study site.

You may not qualify if:

• All other VAMCs and CBOCs.
• Other primary care professionals at a study site.
• Members of special types of PACT teamlets at a study site.

Sponsors & Collaborators

• VA Greater Los Angeles Healthcare System: lead
• VA Office of Research and Development: collaborator

Study Sites (5)

Bakersfield VA Clinic, VA Greater Los Angeles Healthcare System

Bakersfield, California, 93301, United States

NOT YET RECRUITING

Tibor Rubin VA Medical Center, VA Long Beach Healthcare System

Long Beach, California, 90822, United States

NOT YET RECRUITING

West Los Angeles VA Medical Center, VA Greater Los Angeles Healthcare System

Los Angeles, California, 90073, United States

RECRUITING

Sepulveda VA Medical Center, VA Greater Los Angeles Healthcare System

North Hills, California, 91343, United States

NOT YET RECRUITING

Santa Maria VA Clinic, VA Greater Los Angeles Healthcare System

Santa Maria, California, 93454, United States

NOT YET RECRUITING

MeSH Terms

Conditions

Burnout, Psychological

Condition Hierarchy (Ancestors)

Stress, Psychological; Behavioral Symptoms; Behavior

Central Study Contacts

Eric A Apaydin, PhD

CONTACT

310-478-3711; eric.apaydin@va.gov

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: FED
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Health Scientist

Model Details: Four-year modified stepped wedge trial with three interventions sites, separated by one year, and two control sites across the four years.

Study Record Dates

• First Submitted: June 12, 2025
• First Posted: June 22, 2025
• Study Start: October 1, 2025
• Primary Completion (Estimated): September 30, 2028
• Study Completion (Estimated): September 30, 2028
• Last Updated: September 23, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (5)