Policy to Practice: The Intentional Shift Needed to Fix Healthcare Burnout

In a sector defined by relentless demands, the goal of systemic well-being often remains an aspiration rather than a defined strategy. We recently sat down with our own Derek Bell, MS, CWP, VP Solutions & Clinical Operations at VITAL WorkLife, an expert in healthcare well-being strategy, to discuss the critical disconnect between organizational commitments and on-the-ground reality. 

He argues that sustained change requires leaders to shift from implementing well-meaning but siloed programs to establishing well-being as a top-tier policy imperative. The issue is not a lack of effort, but a lack of organizational alignment that prevents a truly whole person, sustained approach from taking root across the system. 

A Conversation with Derek Bell

In your view, what is the biggest disconnect today between an organization's stated commitment to well-being and the reality on the ground for healthcare workers? 

The central issue is that well-being in healthcare is treated reactively, not proactively. It is the equivalent of a patient only going to the doctor when they are already sick, not for preventive care.

Our industry typically waits for a crisis—like widespread clinician burnout—before we try to fix it. Real systemic change requires a commitment to embedding well-being into the very policies and fabric of the organization, treating it as a strategic, preventative investment—that is truly holistic. 

A proactive approach means designing systems that inherently reduce stress, not just offering a coping mechanism after the fact. It means acknowledging that burnout is a system problem, and not a people problem. It is complex, requiring system level thought and strategy to mitigate.  

We often talk about 'culture change,' but what does that actually look like in a complex healthcare system? What is one of the most effective system-level drivers you have seen that moves the needle on clinician well-being? 

This comes down to the distinction between a system and a culture. A system is the tangible commitment—it is what you are committing to. A culture is the collective behavior—it is how you live that commitment. You cannot have a lasting culture of well-being without a committed system to back it up.  

The disconnect occurs when well-being is relegated to sub-areas like HR or EAP administration. This is the wrong place for it. To be effective, well-being must be a core, defined strategy embedded in policy at the highest levels of the organization, where the well-being leadership is at the same table as the senior executives. 

If well-being is not treated as a C-suite initiative with clear metrics that are tied to well-being, it is left up to individual department leaders to implement an undefined strategy with unclear goals. The most effective driver is making well-being a foundational, top-down policy—a strategic objective alongside patient safety and financial performance. Most importantly, well-being must be embedded in the leadership practices of the organization. This is the system level commitment a lot of organizations miss. Few leadership development practices are focused on how to cultivate self-efficacy for leaders in their own well-being and how to create a ripple effect across the organization. In every place I have seen well-being success, it is because leadership was a driver because they themselves were also supporting efforts and modeling it to their teams.

You mentioned how leadership is so critical in these efforts. From your perspective, what is the single most important skill a leader can develop to effectively champion systemic well-being within their own team or organization? 

The most important skill is intentionality—the commitment to "level up" their own leadership capabilities and capacity to support this shift. It is mission critical to support leaders in developing their own well-being skills.  

Leadership is the primary vehicle for driving cultural change, but we must recognize that executive leaders down to middle managers are often struggling themselves. They are trying to implement a profound strategy without necessarily having the behavioral health and emotional intelligence skills required to lead that change effectively. 

We cannot expect our leaders to pour from an empty cup. We must also stop presuming that, because we all agree well-being is good, it is easy to practice and model. The leadership by design concept should include mandatory, annual well-being check-ins and dedicated support for leaders themselves, including well-being skill development. When you take care of your leaders first, you create a powerful trickle-down effect: a healthier leadership team leads to a more thriving employee population, which in turn leads to improved patient care and outcomes. The commitment to self-care is the ultimate act of leadership. This is what I like to call the “middle-out” strategy. Start with the leadership and middle management levels of the organization and train them. They are your drivers and connectors across your entire workforce. Instead of champions of burnout, they must change the paradigm to be champions of well-being.  

Given the struggles executive leaders face, how do you help them become effective drivers of this healthier culture?

We recognize that gap, which is why services like VITAL WorkLife’s Leadership Consultations are essential. Move beyond the status quo, just thinking group therapy is good enough, and shift to leadership-specific, individualized care. Leaders need specialized, confidential support that focuses on skill advancement—how to manage team stress, navigate difficult conversations, and model boundaries. They need their own well-being training.  

For organizations, it means providing leaders with the capacity and tools to manage the human elements of a high-stress system. By intentionally focusing on the well-being of the leadership layer, we equip the entire organization's vehicle for change with a full tank of gas and a professional roadmap. 

Key Takeaway for Leaders

The transition from a reactive approach (fixing burnout after it happens) to a proactive system (preventing it by design) is the defining challenge for healthcare leadership today. This strategic shift requires leadership to move well-being out of the HR silo and into the C-suite policy, acknowledging that investing in the resilience and capacity of your leaders is the fastest route to improving the well-being of every clinician on the frontline. 

What is one tangible policy change your organization can implement this week to signal a shift from reactive crisis management to proactive systemic well-being?