The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: a systematic review

Abstract

ObjectivesThis study reviews the current state of the published peer-reviewed literature related to physician burnout and two quality of care dimensions. The purpose of this systematic literature review is to address the question, ‘How does physician burnout affect the quality of healthcare related to the dimensions of acceptability and safety?’DesignUsing a multiphase screening process, this systematic literature review is based on publically available peer-reviewed studies published between 2002 and 2017. Six electronic databases were searched: (1) MEDLINE Current, (2) MEDLINE In-process, (3) MEDLINE Epub Ahead of Print, (4) PsycINFO, (5) Embase and (6) Web of Science.SettingPhysicians practicing in civilian settings.ParticipantsPracticing physicians who have completed training.Primary and secondary outcome measuresQuality of healthcare related to acceptability (ie, patient satisfaction, physician communication and physician attitudes) and safety (ie, minimising risks or harm to patients).Results4114 unique citations were identified. Of these, 12 articles were included in the review. Two studies were rated as having high risk of bias and 10 as having moderate risk. Four studies were conducted in North America, four in Europe, one in the Middle East and three in East Asia. Results of this systematic literature review suggest there is moderate evidence that burnout is associated with safety-related quality of care. Because of the variability in the way patient acceptability-related quality of care was measured and the inconsistency in study findings, the evidence supporting the relationship between burnout and patient acceptability-related quality of care is less strong.ConclusionsThe focus on direct care-related quality highlights additional ways that physician burnout affects the healthcare system. These studies can help to inform decisions about how to improve patient care by addressing physician burnout. Continued work looking at the relationship between dimensions of acceptability-related quality of care measures and burnout is needed to advance the field.

Burnout in pediatric hematology/oncology—time to address the elephant by name

“…Medical error is the third leading overall cause of death in the United States . There is growing evidence to support the link between medical errors and physician burnout . The largest prospective study of the impact of burnout on patient safety in the United States surveyed 24,922 American College of Surgeons members, of whom 7,905 responded.…”

“…11 There is growing evidence to support the link between medical errors and physician burnout. [12][13][14] The largest prospective study of the impact of burnout on patient safety in the United States surveyed 24,922 American College of Surgeons members, of whom 7,905 responded. The study found that higher levels of burnout are associated with an increased likelihood of reporting an error in the last 3 months, and burnout and depression were among the strongest risk factors for error after adjusting for hours worked and number of calls per week.…”

The association of job demands and resources with burnout among emergency medical services professionals

“…In addition to the negative clinical impacts on individuals, burnout negatively affects workplace organizations. In general, burnout among health care providers has been linked to increased absenteeism and attrition, as well as reduced quality of care and more frequent medical errors, potentially compromising patient safety …”

“…In general, burnout among health care providers has been linked to increased absenteeism and attrition, as well as reduced quality of care and more frequent medical errors, potentially compromising patient safety. [6][7][8][9] According to the Job Demands-Resources Theory, burnout most often results from a prolonged, ongoing imbalance between work demands and job-related resources, whereby work demands significantly exceed job-related resources. 10 Job demands are defined as physical, social, or organizational aspects that require sustained physical or mental effort (eg, physical workload, time pressure, physical environment).…”

Rationing Care through Collaboration and Shared Values

“…These are catastrophic findings for the public as well as for the individual physicians, and rationing through inconvenience is part of the problem. The inconveniences create a minor irritant for patients but contribute to an epidemic of unhappiness, a reduction of clinical availability, and negative impacts on patient care when imposed on physicians …”