Association Between Physician Burnout and Self-reported Errors: Meta-analysis

Abstract

Objectives: Burnout among physicians is an increasingly recognized phenomenon affecting different aspects of patient care and safety. This meta-analysis quantifies association of burnout and its subscales with self-reported medical errors among physicians.Methods: This meta-analysis followed the principles formulated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analyses of Observational Studies. The MEDLINE, PubMed, Web of Science, PsycInfo, and Eric databases were searched until February 5, 2019, using various combinations of key terms without any language restrictions: burnout, physicians, error, safety, and quality. Reference lists of selected studies were hand searched. Data were extracted from published reports. All quantitative studies reporting prevalence of burnout and its association with self-reported errors among physicians were considered. The analyses of heterogeneity (Cochran Q, I 2 ), publication bias (Begg-Mazumdar and Egger), three subgroups, and sensitivity were performed. The effect of overall burnout and Maslach Burnout Inventory subscales on self-reported errors was calculated as odds ratios with 95% confidence interval.Results: Thirteen studies on 20,643 physicians and residents were included. The overall burnout among participants was associated with a significantly increased risk of self-reported errors (odds ratio = 2.72, 95% confidence interval = 2.19-3.37). Emotional exhaustion, depersonalization, and personal accomplishment were all independently predicting factors of self-reported errors. Cochran Q test and inconsistency index I 2 were as follows: Q = 27.2; P = 0.0013, I 2 = 67% (36%-83%). Conclusions:The results provide evidence that not only overall burnout but also its subscales independently are to be associated with a significantly increased risk of self-reported errors among physicians. As self-reported errors may translate into different types of adverse events, this strong and unequivocal association should be of major concern to healthcare organizations.

Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis

“…No previous systematic reviews has taken this approach. 14 15 16 For instance, a meta-analysis published in 2022 that assessed the association of burnout with only self-reported medical errors among physicians found an increased risk of self-reported errors. 16 Two further systematic reviews, 14 15 which assessed the association between physician or healthcare professionals’ wellbeing and burnout with patient safety, did so through a narrative review approach due to large heterogeneity.…”

“…These reciprocal relations should be made available to governments and policy organisations to encourage financial investments and policies to mitigate physician burnout internationally. No previous systematic reviews has taken this approach 141516. For instance, a meta-analysis published in 2022 that assessed the association of burnout with only self-reported medical errors among physicians found an increased risk of self-reported errors 16.…”

Burnout, well-being and self-reported medical errors among physicians

“…The former were however more frequently considered preventable and cost incomparably less to identify [38]. The strength of the association between burnout and selfreported errors in the study (OR=5.33 in the univariable model and OR= 3.81 in the multivariable model) was noticeably greater than the overall odds ratio of 2.72 (95% CI, 2.19-3.37) in the recent meta-analysis that investigated relations between burnout and self-reported errors in 13 studies and over 20 000 physicians [39].…”

Interventions to reduce the incidence of medical error and its financial burden in health care systems: A systematic review of systematic reviews

“…The medical errors can be classified based on their content or “what went wrong” (e.g., medication, surgical, transfusion, healthcare-associated infection) ( 9 – 15 ); location or “where did it happen” (e.g., intensive care unit, operation theater, emergency department, children's ward) ( 15 – 18 ); staff or “who made an error” (e.g., doctor, pharmacists, nurse) ( 10 , 19 , 20 ); error's severity or “how harmful was it” (e.g., error, no harm, near miss) ( 21 – 25 ); and “who was affected” (e.g., patient, family, medical staff) ( 26 , 27 ). Depending on the type of medical errors, studies suggest various solutions, from simple activities (e.g., hand hygiene to prevent healthcare-associated infection) to more complex ones such as using technological instruments or methods to prevent retained surgical instruments errors ( 7 , 15 ).…”