Studies have shown that medical errors are common in the United States healthcare system, representing a major source of inpatient deaths. Evidence indicates that physician burnout, characterized by exhaustion and cynicism, is associated with medical errors. Safety grades provide a summary reflection of the patient safety practices within a patient care setting (or “work unit”) intended to reduce these errors. However, the interactions among these patient safety practices, physician burnout, and medical errors have remained unknown.
For a study published in Mayo Clinic Proceedings, Daniel Tawfik, MD, MS, and colleagues found that both individual physician burnout and work unit safety grades were strongly associated with medical errors, suggesting that attempts at medical error prevention should address both of these aspects in order to maximize their effectiveness.
The study involved a cross-sectional survey of 6,700 physicians in active practice in the US, representing all specialties. Physicians with burnout and those working in areas with low safety grades had higher prevalence of reported errors. Burnout was associated with 2.2 times the odds of reported errors across the sample, even after adjusting for safety grades, gender, age, specialty, work hours, and fatigue.
“The findings suggests that improving patient safety practices within work units is important but not sufficient to create a truly high-quality care system.” Dr. Tawfik said. “A multifaceted approach that also addresses physician burnout is needed. The most effective burnout reduction will require system-level changes to reduce unnecessary documentation and clerical burden, promote efficient use of physicians’ time, align organizational culture with the value of the physicians, demonstrate flexibility and willingness to change, and promote social support among colleagues.”
Tawfik DS, Profit J, Morgenthaler TI, et al. Physician Burnout, Well-being and Work Unit Safety Grades in Relationship to Reported Medical Errors. Mayo Clin Proc. 2018, July 9. [ePub ahead of print]. Available at https://www.mayoclinicproceedings.org/article/S0025-6196(18)30372-0/fulltext