FROM REACTIVE RESPONSE TO INSTITUTIONAL CAPACITY: AN UMBRELLA REVIEW AND PROPOSED FRAMEWORK FOR BURNOUT PREVENTION IN HEALTHCARE SETTINGS

Abstract

Burnout among healthcare professionals has been associated with working conditions, occupational demands, leadership practices, and the resources available to teams during periods of increased pressure. Individual-focused interventions may reduce specific symptoms and strengthen personal resources, but their effects may be limited when relevant causes of exhaustion remain embedded in the work environment. This study aimed to synthesize systematic reviews and meta-analyses addressing organizational interventions, leadership, psychological safety, and institutional support in healthcare settings and, based on this literature, propose a framework for burnout prevention and institutional response. An umbrella review was designed according to PRISMA 2020 and PRIOR recommendations, with searches planned in MEDLINE/PubMed, Embase, CINAHL, PsycINFO, Scopus, and Web of Science for publications between January 2016 and September 2026. Methodological quality will be assessed using AMSTAR 2 and, when appropriate, ROBIS. The literature shows heterogeneous findings for organizational interventions. Changes in working conditions and work processes produce favorable effects in part of the studies, while other interventions show small, null, or inconsistent results. Leadership and psychological safety are associated with workforce well-being and team communication, although much of this evidence is observational. Based on these findings, an institutional model is proposed around four connected functions: assessment of work-related risks, intervention on modifiable factors, leadership preparedness, and outcome monitoring. The framework is presented as a conceptual proposal requiring implementation studies rather than as a previously validated intervention.