uSing Meditation App to Reduce ED occupational sTress (SMART) trial

Grant ID: EMJS-323R31-2019-XU

Project Summary

Our study aims to test whether a mindfulness program delivered by a smartphone app can reduce occupational stress levels among Emergency Department (ED) staff. This study will recruit staff at two regional EDs. Staff will practice short session mindfulness daily, for four weeks, using a smartphone meditation app. The study will determine if, by using the app, staff levels of occupational stress are reduced and overall wellness increased. The levels of stress reduction will be compared before and after the intervention.

Working in an ED can be stressful. It has been suggested that up to half ED doctors and nurses may suffer from burnout due to high workload, overcrowding and limited resources. Staff stress and its negative consequence pose challenging issues to both individual clinicians and healthcare organisations. Sub-optimal wellness of staff is closely associated with poor patient care, more medical incidents and a high staff turnover rate. One way to reduce staff stress levels is by promoting staff coping skills and wellness. Mindfulness is a mental technique to focus self-awareness at the present moment and non-judgmentally. It has been used widely to promote staff workplace wellness. Smartphone apps are a relatively new delivery method for mindfulness that has not yet been tested among ED staff.


The qualitative study found that most participants appreciated the use of the intervention and learned a new way to cope with workplace stress and promote wellbeing. Some participants were able to embed the intervention in their daily life.

A range of perceived benefits, barriers and facilitators were reported by participants, which will be valuable to implement digital mindfulness intervention in ED workforce.

The positive findings of the study will also help organisations to identify a low-cost and feasible stress management and preventative intervention, which could be replicated in other healthcare environment.

Leveraged Funds

- 2019 Queensland Health Innovation, Investment and Research Office (Grant ID QCOS/030853) $14,957



- Xu, H.G., Tuckett, A., Kynoch, K. and Eley, R., 2021. A mobile mindfulness intervention for emergency department staff to improve stress and wellbeing: A qualitative study. International Emergency Nursing, 58, p.101039.

- Xu, H., Eley, R., Kynoch, K. and Tuckett, A., 2021. Effects of mobile mindfulness on emergency department work stress: A randomised controlled trial. Emergency Medicine Australasia.

- Xu, H.G., Kynoch, K., Tuckett, A. and Eley, R., 2020. Effectiveness of interventions to reduce emergency department staff occupational stress and/or burnout: a systematic review. JBI Evidence Synthesis, 18(6), pp.1156-1188.

- Xu, H.G., Kynoch, K., Tuckett, A., Eley, R. and Newcombe, P., 2019. Effectiveness of interventions to reduce occupational stress among emergency department staff: A systematic review protocol. JBI Evidence Synthesis, 17(4), pp.513-519.


- Xu, H. (2021) Promoting emergency department staff wellness- flexibility and adapting to change during the COVID-19 pandemic. 2021 Frontline Mental Health Conference, Gold Coast, Australia (Oral presentation)

- Xu, H., Eley, R., Kynoch, K., Tuckett, A. (2021) Stress, burnout and wellbeing of frontline clinicians in Australian emergency departments: a cross-sectional survey. 22nd International Mental Health Conference, Gold Coast, Australia (Oral presentation)

- Xu, H., Tuckett, A., Kynoch, K., Eley, R. What factors promote clinicians mindfulness practice in the emergency department. 2021 Virtual Doctoral Student Forum, U21 Health Sciences, Australia

- Xu, H., Eley, R., Kynoch, K., Tuckett, A. (2020) Using digital technology to improve emergency department clinicians’ wellbeing – a study protocol. Social for Mental Health Research virtual seminar, Australia (poster presentation).

- Xu, H., Eley, R., Kynoch, K., Tuckett, A (2020) Using a meditation app to mitigate workplace stress in the emergency department- a randomized controlled trial protocol. 21st International Mental Health Virtual Conference, Gold Coast, Australia, October 2020 (Poster/oral presentation).

- Xu, H., et al. (2019) Implementing an emergency department staff wellness program in an Australian hospital: What you can learn from our experience. 17th International Conference for Emergency Nurses, Adelaide, Australia (oral presentation).

- Xu, H., Kynoch, K., Tuckett, A., Eley, R. (2019) Interventions to reduce ED occupational stress: a systematic review. 36th Australasian College for Emergency Medicine Annual Scientific Meeting, Hobart, Australia (poster presentation).

Invited Expert:

- Evidence informed interventions regarding hospital staff stress management. 6th International Nursing Evidence Based Practice virtual Forum, China, October 2020

- How should we navigate future wellness initiatives in ED- lessons learned from a systematic review, Queensland Emergency Department Strategic Advisory Panel (QEDSAP) meeting, Brisbane, Australia, April 2020

- Brief summary of a systematic review regarding occupational stress reduction interventions in ED. QEII Hospital ED Wellness group, Brisbane, Australia, May 2020

- What did we learn from the findings of a systematic review: Interventions to reduce ED occupational stress. Metro South Health & Wellbeing Steering Committee, Brisbane, Australia, April 2020



Amount Awarded


Grant Scheme


Principal Investigator:
Ms Hui (Grace) Xu

Co Investigators:
Dr Anthony Tuckett
Dr Robert Eley
Dr Michael Butterfield

Associate Investigators:
Dr John Sutherland
Ms Tracey McTigue


Collaborating Institutions


  • Ten News First Qld, 3 April 2020
  • CONTACT US +61 7 3720 5700 Suite 1B, Terraces, 19 Lang Parade, Milton Qld 4064