Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors

Abstract

Objective: To evaluate physician burnout, well-being, and work unit safety grades in relationship to perceived major medical errors. Participants and Methods: From August 28, 2014, to October 6, 2014, we conducted a population-based survey of US physicians in active practice regarding burnout, fatigue, suicidal ideation, work unit safety grade, and recent medical errors. Multivariate logistic regression and mixed-effects hierarchical models evaluated the associations among burnout, well-being measures, work unit safety grades, and medical errors. Results: Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P<.001), fatigue (46.6% vs 31.2%; P<.001), and recent suicidal ideation (12.7% vs 5.8%; P<.001). In multivariate modeling, perceived errors were independently more likely to be reported by physicians with burnout (odds ratio [OR], 2.22; 95% CI, 1.79–2.76) or fatigue (OR, 1.38; 95% CI, 1.15–1.65) and those with incrementally worse work unit safety grades (OR, 1.70; 95% CI, 1.36–2.12; OR, 1.92; 95% CI, 1.48–2.49; OR, 3.12; 95% CI, 2.13–4.58; and OR, 4.37; 95% CI, 2.06–9.28 for grades of B, C, D, and F, respectively), adjusted for demographic and clinical characteristics. Conclusion: In this large national study, physician burnout, fatigue, and work unit safety grades were independently associated with major medical errors. Interventions to reduce rates of medical errors must address both physician well-being and work unit safety.

Resident burnout in USA and European urology residents: an international concern

“…Burnout is an occupational hazard, defined as a syndrome of depersonalisation, emotional exhaustion, and reduced feelings of personal accomplishment [1]. Increasing attention is being focused on physician burnout due to its negative effects on both providers and their patients, as burnout is associated with depression suicidality, decreased patient satisfaction, increased risk of medical errors, and higher costs to the healthcare system [2][3][4][5][6][7].…”

Research Priorities for Physician Wellness in Academic Emergency Medicine: Consensus from the Society of Academic Emergency Medicine Wellness Committee

“…Intuitively, physicians who enjoy and are engaged with the practice of medicine are likely to provide better care than those who are not. Preliminary evidence suggests that there is an association between physician burnout and medical errors . Further research in this area is important to understand the nature and severity of this problem.…”

An integrative longitudinal resilience curriculum

“…Medical students are at greater risk than the general population of experiencing depression and burnout, which can lead to medical errors and poorer patient outcomes . The scope of the problem is extensive; however, there is little in the literature on how to address this pressing issue …”