The relationship between resident burnout and safety-related and acceptability-related quality of healthcare: a systematic literature review

Abstract

BackgroundThere has been increasing interest in examining the relationship between physician wellbeing and quality of patient care. However, few reviews have specifically focused on resident burnout and quality of patient care. The purpose of this systematic literature review of the current scientific literature is to address the question, “How does resident burnout affect the quality of healthcare related to the dimensions of acceptability and safety?”MethodsThis systematic literature review uses a multi-step screening process of publicly available peer-reviewed studies from five electronic databases: (1) Medline Current, (2) Medline In-process, (3) PsycINFO, (4) Embase, and (5) Web of Science.ResultsThe electronic literature search resulted in the identification of 4638 unique citations. Of these, 10 articles were included in the review. Studies were assessed for risk of bias. Of the 10 studies that met the inclusion criteria, eight were conducted in the US, one in The Netherlands, and one in Mexico. Eight of the 10 studies focused on patient safety. The results of these included studies suggest there is moderate evidence that burnout is associated with patient safety (i.e., resident self-perceived medical errors and sub-optimal care). There is less evidence that specific dimensions of burnout are related to acceptability (i.e., quality of care, communication with patients).ConclusionsThe results of this systematic literature review suggest a relationship between patient safety and burnout. These results potentially have important implications for the medical training milieu because residents are still in training and at the same time are asked to teach students. The results also indicate a need for more evidence-based interventions that support continued research examining quality of care measures, especially as they relate to acceptability.Electronic supplementary materialThe online version of this article (10.1186/s12909-017-1040-y) contains supplementary material, which is available to authorized users.

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).…”

In Reply—Burnout Is Not Associated With Increased Medical Errors

“…2 To confuse "no proof of effect" with "proof of no effect" is a common mistake well illustrated here. Furthermore, reported medical errors have been found to approximate observed medical errors with 84% congruence, 3 and burnout has consistently been found to relate to poor quality of care, [4][5][6][7] including other objective measures of quality. 8 The second misconception is the distinction between workplace wellness and well-being.…”

“…Yet what is perhaps most problematic about wellness programs and initiatives is that the rhetoric often used to support them may exacerbate prejudice associated with mental disorders and disabilities, 6 erode physicians' employment rights, 6 and result in other unintended adverse effects. Dozens of recent articles regarding the concerns of disability rights advocates about the discriminatory effects of workplace wellness programs on employees with disabilities appear in law and policy journals.…”

Being “nice”: A complex activity among health professionals following a critical incident

“…Ultimately, these reactions can lead to health professionals being more likely to leave the workforce following a critical incident (de Boer et al, 2011;Seys et al, 2013). A literature review by Dewa, Loong, Bonato, Trojanowski, and Rea (2017) found a correlation between errors and burnout, subsequently further impacting performance and patient safety. Supportive environments have the potential to mitigate some of the impact on practitioner well-being and the patient care health professionals provide (Bynum & Goodie, 2014;Pezaro, Clyne, Turner, Fulton, & Gerada, 2016;Pinto, Faiz, & Vincent, 2012;Scott et al, 2010;Wu, Singh-Carlson, Odell, Reynolds, & Yuhua, 2016).…”