Effectiveness of organization-directed interventions on healthcare professionals' well-being: a systematic review

Background: Healthcare professionals' well-being at work seriously influences individuals, organizations, and care quality and safety. Many institutions focus on individual-level approaches. This review evaluates organization-directed interventions targeting the work environment of HCPs, promoting sustainable organizational conditions that support employee well-being and performance over time. Working conditions are considered part of the evidence-based protective factors for well-being at work, aligning with the approach of addressing underlying determinants rather than solely treating individual HCPs. This review aims to assess the effects of organization-directed interventions on hospital staff well-being, work environment, retention, and quality of care. Methods: MEDLINE, Embase, and CINAHL were searched from 2012 to Augustus 2025. Extracted data encompassed study characteristics, population details, intervention and comparator features, and outcomes. The Job Demands–Resources model was used as a theoretical basis. Risk of bias was evaluated. Interventions were categorized into management & building, social resources & support, personal development & recovery, and multi-categorical. Results were synthesized per outcome, effects were explored using forest plots, and the direction of effects is presented by Tables. Data analysis and visualization were performed using Excel and R. The protocol has been registered in May 2022 in PROSPERO (CRD42023390474). Findings: Screening of 3319 hits resulted in 54 included studies. Intervention effects are described and analyzed for outcomes: misconduct, workload, communication, job control, support, team climate, leadership, concentration, coping, efficiency, emotions, psychological characteristics, anxiety, burnout, depression, general health, job satisfaction, lack of energy, physical discomfort, quality of life, sleep, stress, employability, engagement, turnover intentions, patient quality, patient safety, and unwanted events. A total of 419 outcomes were extracted. Most studies showed some risk of bias, and the overall certainty of evidence was rated very low. The effect directions varied widely across outcomes, with standardized mean differences ranging from −3.28 to 3.56 and heterogeneous effects due to non-overlapping confidence intervals in most meta-analyses. Interventions focused on social resources & support, such as the rational emotional intervention, consistently yielded positive effects across different outcome domains. However, some management & building interventions, such as moderated solution meetings, were linked to worse outcomes like lower job satisfaction and quality of life. Interpretation: Findings should be interpreted with caution due to the overall low quality of the evidence. Furthermore, the overall findings are mixed. Some interventions demonstrated beneficial effects for certain outcomes while showing neutral or even detrimental effects for others. These variations underscore the importance of further research with more rigorous study designs, larger sample sizes, a consistent core outcome set, conducting a thorough needs assessment in advance, understanding potential contributors to reduced well-being, and considering local contextual factors before selecting or implementing interventions. Funding: NFU and ZIN.