Background: Healthcare workers are consistently identified as being at heightened risk of burnout. Existing tools (e.g. Maslach Burnout Inventory or Burnout Assessment Tool) provide valuable indicators of burnout prevalence. However, they are often employed to assess the condition after it has occurred. This reactive focus limits opportunities for healthcare organisations to identify and address ‘upstream’ causes and instruments which primarily assess the individual level offer little insight into the modifiable organisational and work-design factors that generate burnout risk. This study outlines the process undertaken to develop and validate a measure intended for diagnosing and monitoring aspects of the work environment that predict burnout risk within healthcare settings – the Leading EAST measure.

The Leading EAST measure captures eight key work-design dimensions (i.e., Role Alignment, Job Clarity, Reasonable Expectations, Consultation and Change, Support for Challenging Work, Support from Leaders, Support with Others, and Personal Development) alongside two individual wellbeing indicators (Psychological Health and Physical Health). Overall, the dimensions aim to capture the engagement of the individual in their role, the individual’s awareness of their work environment, support with and from others, and the transformational role of personal development and individual health.

Aims: Validate the psychometric structure, reliability and predictive validity of the Leading EAST measure.

Method: Multi-phase validation design comprising two independent general-population samples (EFA n=304 and CFA/predictive validity n=278), a general-population test–retest subsample, and a healthcare worker sample (n=223) used to replicate the confirmatory and predictive analyses.

Key findings: Exploratory and confirmatory factor analyses provided strong support for a ten-factor structure that was consistent with the proposed theoretical model. High internal consistency and robust factorial validity in independent general population samples, with replication in an independent healthcare worker sample - supporting the stability and generalisability of the construct within an acute-care population. Organisational conditions characterised by reasonable workload expectations and emotionally challenging work may function as significant individual predictors of burnout. Systemic work conditions explained a substantial variance in burnout risk above and beyond individual factors.

Conclusions: The Leading EAST measure provides an evidence-based approach for healthcare organisations to identify modifiable features of work that may contribute to, or protect against, burnout risk of healthcare workers, and inform interventions which are situated in the organisation’s sphere of influence.

With a focus on workers’ experience of modifiable organisational factors, the measure can inform co-design of positive workplace change, rather than focusing solely on individual-level attributes, such as resilience or burnout alone.