Clarifying the concepts of joy and meaning for work in health care

© Journal of Hospital Management and Health Policy. All rights reserved. J Hosp Manag Health Policy 2021 | http://dx.doi.org/10.21037/jhmhp-21-22 The wellbeing of health care workers is a prime concern in the functioning and performance of health care organizations. While the Triple Aim—enhancing patient experience, improving population health, and reducing health care costs—has contributed to health system reforms worldwide, scholars have asserted the need for a fourth aim to improve the professional lives of health care workers (1). Such improvements promote work engagement, job satisfaction, and talent retention; protect against the increasingly prevalent phenomenon of burnout among clinicians; and are essential for the quality and safety of care (2). They prompt health care leaders and managers to pay more attention to issues such as physicians’ experiences of autonomy loss and stress related to malpractice liability, as well as nurses’ experiences of disrespectful behaviors at work for example. More specifically, the Quadruple Aim is a call to help health care workers restore and maintain “joy and meaning in work” (3). Similarly, the Institute for Healthcare Improvement has promoted joy in work as a goal for organizations to work towards (4). The concepts of joy and meaning can however be elusive when health care leaders and managers seek to implement and evaluate workplace interventions to increase workplace wellbeing. This is because both concepts are used and defined in everyday discourse in a myriad of ways, including as a state of being, as a process of self-transcendence, or in relation to spiritual beliefs (5). Not only do these definitions preclude a consistency in which health care leaders and managers approach joy and meaning at work, there is also a wide array of conceptual definitions for and instruments to measure joy and meaning in the scientific literature (6). To make the concepts of joy and meaning in work more relevant to the health care context, we highlight some key insights from psychological research via a concept analysis in this paper. We first discuss the definitions of both concepts and how they relate to wellbeing at work more broadly. We then distinguish the nuances between (I) joy and meaning in and at work, and (II) meaning and meaningfulness. Finally, we discuss how health care workers can achieve meaningfulness through having an impact on others, workplace relationships, and professional development. By elaborating these concepts as well as their antecedents, we aim to highlight some dimensions that health care leaders and managers should consider when improving the wellbeing of health care workers.