Promise and Perils of Leader-Employee Check-ins in Reducing Emotional Exhaustion in Primary Care Clinics: Quasi-Experimental and Qualitative Evidence

Objective: To analyze the role of short (<30 minutes) and frequent (quarterly) check-ins between clinic leaders and employees in reducing emotional exhaustion. Methods: Three interrelated studies were conducted: a 3-year repeated cross-sectional survey at 10 primary care clinics (n=505; we compared emotional exhaustion, perceived stress, and values alignment among employees of a clinic where check-ins were conducted vs 9 control clinics); interviews with leaders and employees (n=10) regarding the check-ins process and experiences; and interviews with leaders and employees (n=10) after replicating the check-ins at a new clinic. Results: Outcomes were similar at baseline. After a year, emotional exhaustion was lower at the check-ins compared with control clinics (standardized mean difference, d, −0.71 [P<.05]). After 2 years, emotional exhaustion remained lower at the check-ins clinic, but this difference was not significant. The check-ins were associated with an increment in values alignment (2018 vs 2017, d=0.59 [P<.05]; 2019 vs 2017, d=0.76 [P<.05]). There were no differences for perceived job stress. Interviews indicated that work-life challenges were discussed in the check-ins. However, employees need confidentiality and to feel safe to do so. The replication suggested that the check-ins are feasible to implement even amid turbulent times. Conclusion: Periodic check-ins wherein leaders acknowledge and address work-life stressors might be a practical tactic to reduce emotional exhaustion in primary care clinics.