Physician Burnout and Medical Errors: Exploring the Relationship, Cost, and Solutions.

Physician burnout has demonstrated risks to providers and patients through medical errors. This review aims to synthesize current data surrounding burnout and its impacts on quality to inform targeted interventions that benefit providers and patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping review methodology was utilized to identify studies of quantitative metrics for burnout and medical errors. Three independent reviewers conducted screening, study selection, and data extraction. Of 1096 identified articles, 21 were analyzed. Overall, 80.9% used the Maslach Burnout Inventory to evaluate for burnout. Moreover, 71.4% used self-reported medical errors as their primary outcome measure. Other outcome measures included observed/identified clinical practice errors and medication errors. Ultimately, 14 of 21 studies found links between burnout and clinically significant errors. Significant associations exist between burnout and medical errors. Physician demographics, including psychological factors, well-being, and training level, modulate this relationship. Better metrics are necessary to quantify errors and their impacts on outcomes. These findings may inform novel interventions that target burnout and improve experiences.

[1]  M. Linzer,et al.  Trends in Clinician Burnout With Associated Mitigating and Aggravating Factors During the COVID-19 Pandemic , 2022, JAMA health forum.

[2]  Lindsey E. Carlasare,et al.  Changes in Burnout and Satisfaction With Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic , 2022, Mayo Clinic Proceedings.

[3]  Sunny S. Lou,et al.  Temporal Associations Between EHR-Derived Workload, Burnout, and Errors: a Prospective Cohort Study , 2022, Journal of General Internal Medicine.

[4]  T. Shanafelt,et al.  Assessment of Physician Sleep and Wellness, Burnout, and Clinically Significant Medical Errors. , 2020, JAMA network open.

[5]  Lindsey E. Carlasare,et al.  Association of Physician Burnout With Suicidal Ideation and Medical Errors , 2020, JAMA network open.

[6]  Revathi Jyothindran,et al.  Fulfillment, burnout and resilience in emergency medicine—Correlations and effects on patient and provider outcomes , 2020, PloS one.

[7]  J. Moskowitz,et al.  Evaluating the Association of Multiple Burnout Definitions and Thresholds With Prevalence and Outcomes. , 2020, JAMA surgery.

[8]  M. Mańczak,et al.  Association Between Physician Burnout and Self-reported Errors: Meta-analysis , 2020, Journal of patient safety.

[9]  J. Moskowitz,et al.  Association of Surgical Resident Wellness With Medical Errors and Patient Outcomes , 2020, Annals of surgery.

[10]  W. Shrank,et al.  Waste in the US Health Care System: Estimated Costs and Potential for Savings. , 2019, JAMA.

[11]  Amy J. Starmer,et al.  Association of Pediatric Resident Physician Depression and Burnout With Harmful Medical Errors on Inpatient Services. , 2019, Academic medicine : journal of the Association of American Medical Colleges.

[12]  Joel Goh,et al.  Estimating the Attributable Cost of Physician Burnout in the United States , 2019, Annals of Internal Medicine.

[13]  L. Dyrbye,et al.  Physician Burnout, Well‐being, and Work Unit Safety Grades in Relationship to Reported Medical Errors , 2018, Mayo Clinic proceedings.

[14]  N. Lawson Burnout is Not Associated With Increased Medical Errors. , 2018, Mayo Clinic proceedings.

[15]  J. McGowan,et al.  PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation , 2018, Annals of Internal Medicine.

[16]  L. Dyrbye,et al.  Physician burnout: contributors, consequences and solutions , 2018, Journal of internal medicine.

[17]  L. Roberts,et al.  A Brief Instrument to Assess Both Burnout and Professional Fulfillment in Physicians: Reliability and Validity, Including Correlation with Self-Reported Medical Errors, in a Sample of Resident and Practicing Physicians , 2017, Academic Psychiatry.

[18]  A. Darzi,et al.  Improving Care And Lowering Costs: Evidence And Lessons From A Global Analysis Of Accountable Care Reforms. , 2017, Health affairs.

[19]  M. Rothberg,et al.  Empathy, burnout, and antibiotic prescribing for acute respiratory infections: a cross-sectional primary care study in the US. , 2017, The British journal of general practice : the journal of the Royal College of General Practitioners.

[20]  M. Panda,et al.  Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review. , 2017, Journal of graduate medical education.

[21]  R. Vinci,et al.  Pediatric Resident Burnout and Attitudes Toward Patients , 2017, Pediatrics.

[22]  J. Ripp,et al.  The Effect of Burnout on Medical Errors and Professionalism in First-Year Internal Medicine Residents. , 2016, Journal of graduate medical education.

[23]  Ian Watt,et al.  Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review , 2016, PloS one.

[24]  Roger L. Brown,et al.  Predictors and Outcomes of Burnout in Primary Care Physicians , 2016, Journal of primary care & community health.

[25]  M. Gisondi,et al.  Impact of Burnout on Self-Reported Patient Care Among Emergency Physicians , 2015, The western journal of emergency medicine.

[26]  A. Wu,et al.  Residency schedule, burnout and patient care among first-year residents , 2013, Postgraduate Medical Journal.

[27]  R. McCarthy,et al.  The Prevalence of Burnout and Depression and Their Association with Adherence to Safety and Practice Standards: A Survey of United States Anesthesiology Trainees , 2013, Anesthesia and analgesia.

[28]  J. Van Den Bos,et al.  The $17.1 billion problem: the annual cost of measurable medical errors. , 2011, Health affairs.

[29]  J. Freischlag,et al.  Burnout and Medical Errors Among American Surgeons , 2010, Annals of surgery.

[30]  T. Habermann,et al.  Association of resident fatigue and distress with perceived medical errors. , 2009, JAMA.

[31]  Mark D Schwartz,et al.  Working conditions in primary care: physician reactions and care quality. , 2009, Annals of internal medicine.

[32]  T. Sectish,et al.  Rates of medication errors among depressed and burnt out residents: prospective cohort study , 2008, BMJ : British Medical Journal.

[33]  T. Habermann,et al.  Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. , 2006, JAMA.

[34]  Tait Shanafelt,et al.  Burnout and Self-Reported Patient Care in an Internal Medicine Residency Program , 2002, Annals of Internal Medicine.

[35]  Charles Andel,et al.  The economics of health care quality and medical errors. , 2012, Journal of health care finance.

[36]  J. Orlowski,et al.  Critical care stress and burnout. , 1986, Critical care clinics.