TY - JOUR
T1 - Sick leave and engagement as workforce well-being proxies in hospital departments
T2 - a cross-sectional study of routinely collected organisational data in a Dutch academic hospital
AU - Bazuin, Tom
AU - Oerbekke, Michiel S.
AU - Bontjer, Saskia
AU - Reijmerink, Iris M.
AU - Dongelmans, Dave A.
AU - Franx, Arie
AU - Wietasch, J. K.Götz
AU - Hooft, Lotty
AU - van der Laan, Maarten J.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/.
PY - 2026/4/1
Y1 - 2026/4/1
N2 - OBJECTIVES: Well-being of healthcare professionals (HCPs) is vital for care quality, staff retention and overall healthcare system effectiveness. This study aims to identify the organisational and workplace variables associated with sick leave and measures of engagement of HCPs on department level within a single Dutch academic hospital. DESIGN: Cross-sectional study using routinely collected organisational data. SETTING: A tertiary-care academic hospital in the Netherlands. PARTICIPANTS: 25 clinical departments were included. Department level variables were derived from routinely collected hospital databases. Availability of data varied across variables. Analysis included information on patient population, human resources, care processes, quality of care and employee and patient experiences to assess differences, correlations and predictors for sick leave and engagement. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome measures were (1) sick leave (%) and (2) engagement, assessed through two staff-survey items (vitality and connectedness; 0-10 Numeric Rating Scale). Both outcomes were analysed at department level. RESULTS: Employee population data showed the most consistent patterns across analyses. Departments with higher staffing capacity had higher sick leave and lower engagement in group comparisons (p=0.009, p=0.030, respectively). In multivariable models, higher staffing capacity remained associated with increased sick leave (B=1.38, 95% CI 0.53 to 2.23, p=0.003). Engagement was positively associated with higher inflow (B=0.92, 95% CI 0.06 to 1.77, p=0.037) and negatively associated with outflow (B = -1.36, 95% CI -2.08 to -0.63, p=0.001). No consistent associations were found with patient population and patient experience measures. CONCLUSIONS: Workforce-related factors, particularly staffing capacity and inflow and outflow, are strongly linked to sick leave and engagement. Routinely collected hospital data can be used to identify at-risk departments and inform targeted strategies for improving workforce sustainability. Future studies should explore more granular, team-level data to better support staff well-being and care quality.
AB - OBJECTIVES: Well-being of healthcare professionals (HCPs) is vital for care quality, staff retention and overall healthcare system effectiveness. This study aims to identify the organisational and workplace variables associated with sick leave and measures of engagement of HCPs on department level within a single Dutch academic hospital. DESIGN: Cross-sectional study using routinely collected organisational data. SETTING: A tertiary-care academic hospital in the Netherlands. PARTICIPANTS: 25 clinical departments were included. Department level variables were derived from routinely collected hospital databases. Availability of data varied across variables. Analysis included information on patient population, human resources, care processes, quality of care and employee and patient experiences to assess differences, correlations and predictors for sick leave and engagement. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome measures were (1) sick leave (%) and (2) engagement, assessed through two staff-survey items (vitality and connectedness; 0-10 Numeric Rating Scale). Both outcomes were analysed at department level. RESULTS: Employee population data showed the most consistent patterns across analyses. Departments with higher staffing capacity had higher sick leave and lower engagement in group comparisons (p=0.009, p=0.030, respectively). In multivariable models, higher staffing capacity remained associated with increased sick leave (B=1.38, 95% CI 0.53 to 2.23, p=0.003). Engagement was positively associated with higher inflow (B=0.92, 95% CI 0.06 to 1.77, p=0.037) and negatively associated with outflow (B = -1.36, 95% CI -2.08 to -0.63, p=0.001). No consistent associations were found with patient population and patient experience measures. CONCLUSIONS: Workforce-related factors, particularly staffing capacity and inflow and outflow, are strongly linked to sick leave and engagement. Routinely collected hospital data can be used to identify at-risk departments and inform targeted strategies for improving workforce sustainability. Future studies should explore more granular, team-level data to better support staff well-being and care quality.
KW - Cross-Sectional Studies
KW - Health policy
KW - Health Workforce
KW - Organisation and Administration
UR - https://www.scopus.com/pages/publications/105034818514
U2 - 10.1136/bmjopen-2025-109196
DO - 10.1136/bmjopen-2025-109196
M3 - Article
C2 - 41922050
AN - SCOPUS:105034818514
SN - 2044-6055
VL - 16
JO - BMJ Open
JF - BMJ Open
IS - 4
M1 - e109196
ER -