A Multi-Department Investigation of Occupational Well-Being, Systemic Features, and Organizational Outcomes in Anesthesiology Using the Well-Being Influencers Survey for Healthcare (WISH)

Abstract

BACKGROUND: High rates of distress and intention to leave (ITL) threaten workforce stability and patient care in anesthesiology. Meaningful action is believed to require evidence-based insight into the systemic origins of occupational well-being shaping these risks. However, the field has lacked large-scale insights into these systemic features and their influence on well-being and its consequences using validated tools. The Well-Being Influencers Survey for Healthcare (WISH) was developed to provide a framework and metric for understanding organizational foundations of well-being. This study evaluated WISH's generalizability across a multicenter cohort, examined the relevance of system-oriented assessment, and characterized the current profile of well-being culture in anesthesiology.METHODS: Participants across 11 academic anesthesiology departments completed WISH alongside occupational well-being correlates. Mediation models examined theoretical relationships among well-being influencers, cognitive-affective states, and organizational outcomes. ANOVA assessed differences in WISH by influencer, department, and professional role. Psychometric techniques were used to extend validity evaluation of WISH, pooling data for higher-power and using meta-analysis to assess generalizability.RESULTS: Newly collected responses from 1470 health workers were analyzed. Multidimensional psychometric models met fit criteria. In meta-analytic summaries of departmental-level estimates, WISH significantly predicted ITL ( b = -0.45) and affective commitment (AC, b = 0.81), including after controlling for well-being correlates. Mediation results were consistent with a model in which WISH influencers are upstream of cognitive-affective states and, in turn, organizational outcomes; of the total association between WISH and organizational outcomes, most (53% for ITL, 64% for AC) was attributable to WISH directly. ANOVA identified significant differences between WISH influencers: organizational justice scored lowest, whereas perceived social support, psychological safety, and inclusion and belonging scored highest.CONCLUSION: WISH identifies systemic features associated with well-being and its consequences, including ITL. Multicenter findings extend validation evidence for WISH, clarify the relevance of system-oriented assessment, and characterize the profile of well-being culture in academic anesthesiology.