Introduction The changes in the organisation of the healthcare system, actually involving the Italian healthcare hospital departments, triggered by the current economic crisis, in addition to ongoing technological innovation and developments in society, increase the exposure of healthcare workers (HCWs) to work related stress (WRS). Emergency Department (ED) workers are particularly vulnerable to WRS as a consequence of specific occupational risk factors typical of ED’s healthcare professions.

Methods The authors conducted an integrated analysis of stress sentinel indicators and of objective stress factors of occupational context and content areas, among nurses and physicians of three Italian hospital EDs, in accordance to the multidimensional validated tool developed in Italy by National Network for Prevention of Work-Related Psychosocial Disorders. The aim of this observational study was to analyse the level of WRS after improvement interventions implemented by the management staff of EDs which focused on work context factors.

Results The assessment of WRS showed that nurses and physicians of the investigated EDs were exposed to a medium level of risk; the improvement interventions aimed at reducing WRS and focused on the following work context factors:

• Function and organisational culture;

• Role within the occupational organisation;

• Relationship at work, resulted significantly effective in minimising the risk of WRS.

Discussion In this study the implementation of improvement interventions focused on team development, safety training programs and adoption of the ethics code for healthcare workers, showed to be an effective and also measurable way to significantly reduce the level of WRS risk at workplace. Head Physicians and Head Nurses of EDs should consider that stress management programs aimed to improve work context factors associated with occupational stress are effective in minimising the impact of WRS on ED workers.