Quiet Quitting in the Healthcare Workforce: A Systematic Review of Organisational Drivers and Managerial Implications.

BACKGROUND

Quiet quitting refers to employees limiting their efforts to core job responsibilities without engaging in extra-role activities. Quiet quitting is a relevant social issue, and it represents a deeper pattern of disengagement driven by perceived undervaluation, workload pressures and organisational disconnection. In healthcare, this phenomenon is particularly critical given its potential impact on workforce sustainability, job satisfaction and quality of care.

OBJECTIVES

To synthesise evidence on quiet quitting among hospital healthcare workers, with a specific focus on identifying and critically analysing its organisational and occupational drivers, as well as its prevalence and associated sociodemographic factors.

METHODS

A systematic search of PubMed, Scopus and EBSCO (CINAHL, PsycINFO, PsycArticles, Psychology and Behavioural) was conducted for quantitative studies published in English between January 2015 and August 2025. Eligible studies assessed quiet quitting in healthcare workers using validated instruments or single-item indicators. Methodological quality was assessed with the Joanna Briggs Institute checklist. Data were narratively synthesised. The protocol was registered in PROSPERO (CRD420251114378) in August 2025.

RESULTS

Fourteen cross-sectional studies including 8279 healthcare workers were included. Reported prevalence of quiet quitting ranged from 46.1% to 74.4%. Burnout, job dissatisfaction, work stress, leadership style, organisational support and work environment were consistently associated with higher levels of QQ. Conversely, engaging leadership, supportive environments and higher emotional intelligence were linked to lower quiet quitting. Evidence regarding demographic correlates was heterogeneous; some studies suggested higher prevalence among younger workers, including Generation Z. Most studies were rated as moderate to high quality.

CONCLUSIONS

Quiet quitting is common among healthcare workers and appears to be influenced by occupational and organisational factors. Findings should be interpreted with caution due to the cross-sectional designs, heterogeneous measurement approaches and limited cross-cultural validation. Future longitudinal and interventional studies should examine whether and how quiet quitting affects workforce sustainability, care quality and patient outcomes across diverse healthcare settings.

IMPLICATIONS FOR NURSE LEADERS: Nurse leaders and managers should address quiet quitting through participatory and empowering leadership, shared governance, professional recognition, organisational support, and fair staffing and workload allocation. Creating psychologically safe and supportive work environments that foster teamwork, well-being and engagement may strengthen nurses' sense of belonging, reduce disengagement and support workforce retention and sustainability.