Medical errors: caused by burnout or unsafe healthcare settings?

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Medical errors are said to be responsible for 100,000 to 200,000 deaths in the U.S. each year. While medical errors are common, there is limited data on how physician burnout contributes to such mistakes. A new Stanford-led study shows that medical errors may stem more from physician burnout than unsafe healthcare settings. 

Researchers conducted a population-based survey of U.S. physicians in active practice. Of the 6,695 who responded, 3,574 (55 percent) reported symptoms of burnout. Ten percent also reported that they had made at least one major medical error during the prior three months, a figure consistent with previous published research, the study said. The physicians were also asked to rank safety levels in the hospitals or clinics where they worked using a standardised question to assess work unit safety.

"We found that physicians with burnout had more than twice the odds of self-reported medical error, after adjusting for speciality, work hours, fatigue and work unit safety rating," said lead author Daniel Tawfik, MD, an instructor in paediatric critical care medicine at Stanford University School of Medicine. "We also found that low safety grades in work units were associated with three to four times the odds of medical error."

The findings suggest that interventions to reduce rates of medical errors must address both physician well-being and work unit safety, according to the study published online in Mayo Clinic Proceedings. 

"What we find in this study is that physician burnout levels appear to be equally, if not more, important than the work unit safety score to the risk of medical errors occurring," explained senior author Tait Shanafelt, MD, director of the Stanford WellMD Center and associate dean of the School of Medicine. "If we are trying to maximise the safety and quality of medical care, we must address the factors in the work environment that lead to burnout among our healthcare providers." 

Physician burnout has become a national epidemic, with multiple studies indicating that about half of all doctors experience symptoms of exhaustion, cynicism and feelings of reduced effectiveness. The new study notes that physician burnout also influences quality of care, patient safety, turnover rates and patient satisfaction.

Survey results also revealed that rates of medical errors actually tripled in medical work units, even those ranked as extremely safe, if physicians working on that unit had high levels of burnout. 

"Up until just recently, the prevailing thought was that if medical errors are occurring, you need to fix the workplace safety with things like checklists and better teamwork," Dr. Tawfik said. "This study shows that that is probably insufficient. We need a two-pronged approach to reduce medical errors that also addresses physician burnout." 

In addition to their effect on patients, both errors and burnout can also have serious personal consequences for physicians. "We also know from our previous work that both burnout and medical errors independently double the risk of suicidal thoughts among physicians," Dr. Shanafelt said. "This contributes to the higher risk of death by suicide among physicians relative to other professionals."

Image Credit: Pixabay 

References:

Tawfik DS, Profit J, Shanafelt TD et al. (2018) Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors. Mayo Clin Proc. Published online: July 09, 2018. DOI: https://doi.org/10.1016/j.mayocp.2018.05.014

Published on : Tue, 17 Jul 2018



medical errors, burnout, workplace safety Medical errors: caused by burnout or unsafe healthcare settings?

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