An evidence-informed framework for workforce well-being and burnout prevention in emergency medicine

The practice of emergency medicine is characterized by high acuity, crowding, and frequent exposure to trauma and moral distress. Consistent with the National Academy of Medicine's Quintuple Aim, threats to workforce well-being, including high rates of burnout, remain among the most pressing challenges in emergency medicine and are strongly associated with reduced quality of care and workforce attrition. While earlier discourse has disproportionately emphasized individual "resilience," contemporary scholarship indicates that burnout and impaired well-being are fundamentally systems-driven outcomes, arising from structural and organizational factors. The Quintuple Aim posits five interconnected aims that are in dire need of systematic improvement to provide ideal healthcare. This narrative, evidence-informed review acknowledges the interconnectedness of the five aims but focuses specifically on Aim 4, workforce well-being. What follows is a review of current literature supporting systems-level interventions addressing workforce well-being as a critical outcome metric. Drawing on this literature, we propose actionable strategies organized into three domains: (1) redesigning work and workflows, (2) cultivating a culture of wellness and psychological safety, inclusive of leadership development, and (3) supporting care teams routinely and after adversity. While no individual intervention serves as a panacea, efforts to improve workforce well-being are essential to the present and future of Emergency Medicine.