Burnout Detection Report Template
Copy and fill this template when analyzing burnout risk using Culture Index Survey vs Job comparison.
Overview
Burnout Detection Report Template
Copy and fill this template when analyzing burnout risk using Culture Index Survey vs Job comparison.
Burnout Risk Assessment: [Name]
Date: [Date] Data Source: [PDF/JSON] Pattern: [Archetype]
Energy Utilization
| Metric | Value |
|---|---|
| Survey EU | [value] |
| Job EU | [value] |
| Utilization | [Job/Survey × 100]% |
Status Classification
| Range | Status | This Person |
|---|---|---|
| 70-130% | Healthy | [ ] |
| >130% | STRESS (burnout risk) | [ ] |
| <70% | FRUSTRATION (flight risk) | [ ] |
Current Status: [Healthy/Stress/Frustration]
Arrow Movement
| Graph | Arrow Position | Delta |
|---|---|---|
| Survey | [value] | - |
| Job | [value] | [±X] |
Interpretation: [Arrow moved right = stress / Arrow moved left = frustration / No movement = stable]
Trait Modification Analysis
| Trait | Survey | Job | Change | Interpretation |
|---|---|---|---|---|
| A | [pos from arrow] | [pos from arrow] | [±X] | [meaning] |
| B | [pos from arrow] | [pos from arrow] | [±X] | [meaning] |
| C | [pos from arrow] | [pos from arrow] | [±X] | [meaning] |
| D | [pos from arrow] | [pos from arrow] | [±X] | [meaning] |
Most Significant Modifications
- [Trait]: [Survey pos] → [Job pos] ([interpretation])
- [Trait]: [Survey pos] → [Job pos] ([interpretation])
Red Flags Detected
| Signal | Present | Details |
|---|---|---|
| EU 0-10 (avoidant) | [Y/N] | [details] |
| All dots flipped sides | [Y/N] | [details] |
| D raised significantly | [Y/N] | [details] |
| Arrow shifted >2 positions | [Y/N] | [details] |
| Utilization >150% | [Y/N] | [details] |
| Utilization <50% | [Y/N] | [details] |
Risk Assessment
| Factor | Finding | Risk Level |
|---|---|---|
| EU Utilization | [%] | [Low/Medium/High/Critical] |
| Trait Modifications | [summary] | [Low/Medium/High/Critical] |
| Arrow Movement | [summary] | [Low/Medium/High/Critical] |
| Overall Risk | - | [Low/Medium/High/Critical] |
Root Cause Hypothesis
Based on the modification pattern, likely causes include:
- [Cause 1]: [explanation based on specific trait changes]
- [Cause 2]: [explanation based on specific trait changes]
Recommended Actions
Immediate (if High/Critical):
- [Immediate action]
- [Immediate action]
Short-term:
- [Short-term action]
- [Short-term action]
Ongoing:
- [Ongoing monitoring action]
Questions to Explore
- [Question to ask in 1:1 based on modifications]
- [Question to ask in 1:1 based on modifications]
- [Question to ask in 1:1 based on modifications]
Resurvey Recommendation
| Current Risk | Resurvey In |
|---|---|
| Low | 6 months |
| Medium | 3 months |
| High | 1-2 months |
| Critical | After intervention |
Next resurvey: [Date]
Burnout analysis based on Survey vs Job comparison. Survey = hardwired traits; Job = adaptive behaviors. Sustained behavior modification drains energy. This assessment is one input - combine with direct conversation and observation.