The AHRQ PSNet Collection comprises an extensive selection of resources relevant to the patient safety community. These resources come in a variety of formats, including literature, research, tools, and Web sites. Resources are identified using the National Library of Medicine’s Medline database, various news and content aggregators, and the expertise of the AHRQ PSNet editorial and technical teams.
Shanafelt TD, West CP, Dyrbye LN, et al. Mayo Clinic Proc. 2022;97:2248-2258.
The COVID-19 pandemic has increased attention on clinician burnout and well-being. This survey of 2,440 US physicians identified an increase in burnout and decrease in satisfaction with work-life integration during the COVID-19 pandemic. Compared with earlier surveys (in 2011, 2014, 2017 and 2020), respondents reported higher mean emotional exhaustion scores, depersonalization scores, and burnout symptoms.
Dyrbye LN, West CP, Sinsky CA, et al. JAMA Netw Open. 2022;5:e2213080.
Burnout is characterized as emotional exhaustion, depersonalization, and decreased sense of accomplishment at work which results in overwhelming negative emotions. Earlier studies have focused on the association of burnout with the electronic medical record and the COVID-19 pandemic, among others. This study focused on the association of physician burnout and mistreatment by patients, families and visitors. Survey respondents reported experiencing mistreatment (e.g., racially or ethnically offensive remarks) and discrimination (e.g., patients or families refusing to allow the physician to provide treatment based on their gender, race, or ethnicity) in the past year. Experiencing mistreatment or discrimination was associated with burnout.
Rotenstein LS, Melnick ER, Sinsky CA. JAMA. 2022;327:2079-2080.
Clinician well-being is increasingly seen as a quality and safety issue. This commentary discusses how systemic efforts must be built to enhance occupational well-being among clinicians. This approach discussed should consider both human factors and organizational design strategies to reduce burnout, cognitive overload, process frustration, and technology use.
Menon NK, Shanafelt TD, Sinsky CA, et al. JAMA Netw Open. 2020;3:e2028780.
Burnout may adversely affect physician wellness and consequently patient safety. This cross-sectional study of 1,354 physicians found that depression was associated with suicidal ideation, while burnout was associated with self-reported medical errors.
Harry EM, Sinsky CA, Dyrbye LN, et al. Jt Comm J Qual Patient Saf. 2021;47:76-85.
… effect on wellbeing of health care professionals. Among a sample of US physicians, the authors of this study found … setting, specialty, and hours worked per week. … Harry E, Sinsky C, Dyrbye LN, et al. Physician task load and the risk of burnout among US physicians in a national survey. Jt Comm J Qual Patient Saf. 2020. Epub …
Han S, Shanafelt TD, Sinsky CA, et al. Ann Intern Med. 2019;170:784-790.
Burnout may adversely affect patient safety as well as physician wellness. While health care organizations are increasingly focused on measuring burnout and implementing targeted interventions for improvement, the financial costs associated with physician burnout are not well described. In this study, researchers estimate that in the United States, $4.6 billion in costs are incurred from physician turnover and reduced work hours related to burnout on an annual basis. They estimate that the cost for organizations is about $7600 per physician each year. These findings suggest that physician burnout is associated with substantial economic burden. An Annual Perspective discussed burnout and its effect on patient safety.
Tawfik DS, Profit J, Morgenthaler TI, et al. Mayo Clin Proc. 2018;93:1571-1580.
… Clinic proceedings … Mayo Clin Proc … Physician burnout is a highly prevalent patient safety concern. Researchers … with prior studies . More than 10% of respondents reported a major medical error in the prior 3 months, and these rates …
Holman T, Waldren SE, Beasley JW, et al. J Am Med Inform Assoc. 2018;25:694-701.
In this study, researchers queried family physicians regarding the utility and challenges associated with meaningful use. Respondents' perceptions were highly variable. Some criteria were perceived as beneficial to patient care, but others were considered burdensome.
Linzer M, Sinsky CA, Poplau S, et al. Health Aff (Millwood). 2017;36:1808-1814.
Clinician burnout is a pressing patient safety issue. This pre–post study found that improving clinicians' work conditions (e.g., chaos, communication, values alignment, and cohesion) led to a subsequent reduction in burnout and increased likelihood of remaining in their medical practices. The findings suggest that clinicians' satisfaction can be improved by addressing workplace conditions.
Sinsky CA, Colligan L, Li L, et al. Ann Intern Med. 2016;165.
Time spent with the electronic health record and performing administrative tasks has been linked to physician burnout, an important patient safety problem. This study used direct observation and time diaries to characterize the work of outpatient physicians. Investigators found that physicians spent about one-quarter of their time face-to-face with patients. Nearly half their work day was spent using the electronic health record and doing desk work. Participating clinicians spent 1–2 additional hours on the electronic health record at night. A PSNet interview with lead author Christine Sinsky calls for improving physician work satisfaction in order to improve patient safety.
Shanafelt TD, Hasan O, Dyrbye LN, et al. Mayo Clin Proc. 2015;90:1600-13.
Physician burnout can impact patient safety. Prior research has shown that burnout is associated with lower reported quality and safety. This survey study of physicians found that more than half reported one or more symptoms of burnout. In contrast to other adults in the United States, rates of burnout are increasing among physicians. This work adds to the growing calls for addressing the causes of physician burnout. An Annual Perspective discussed burnout among health care professions as it relates to patient safety.