Do work condition interventions affect quality and errors in primary care? Results from the Healthy Work Place Study.
Burnout among clinicians is a widespread patient safety concern. This study compared usual outpatient medical care to an intervention designed to improve clinician working conditions, with the aim of reducing medical errors and enhancing performance on a bundle of care quality measures. The intervention included an assessment of clinician perceptions of working conditions and well-being followed by a locally designed quality improvement project. Each clinic designed an intervention to address the concerns that arose from the assessment. Some clinics chose to work on improving communication or team-based chronic disease management while others focused on redesigning the clinic workflow. Investigators randomized 34 clinics either to receive the intervention or to continue their usual practice and found no differences in medical error rates or care quality measures between the clinics. The authors determined that reducing clinician burnout may not necessarily enhance patient safety and conclude that longer-term, standardized improvement interventions may be needed to augment health care quality.