Stanford Study Links Medical Errors to Physician Burnout


The epidemic of physician burnout may be the source of even more medical errors than unsafe medical workplace conditions, a new study led by Stanford researchers has found.

Physician burnout is at least equally responsible for medical errors as unsafe medical workplace conditions, if not more so, according to a study led by researchers at the Stanford University School of Medicine.
“If we are trying to maximize the safety and quality of health services, we must address the factors that lead to exhaustion among our health care providers,” says Stanford WellMD Center Director and colleague deputy Tait Shanafelt Medical School. “Many system level changes are being implemented to improve the safety of our patients in our medical workplaces. In this study, we see that physician burnout levels are equally important from the security score of the business unit, though not more than the risk of emergence of medical errors. “

The study was published in the Mayo Clinic Proceedings on July 9th. Shanafelt, a hematology professor and Professor of Jeanie and Stew Ritchie, is a senior writer. Daniel Tawfik, a pediatric care practitioner in Stanford, is the head writer.

National Outbreak
There are medical errors in the United States. Previous work estimates that these errors are responsible for 100,000 to 200,000 deaths each year. However, a limited research has focused on how the depletion of the doctor contributes to this mistake, according to the new study.

Researchers sent surveys to physicians in active practice across the United States. 3,574-55 percent of 6,695 respondents reported burnout. The study noted that 10 percent was consistent with a previous published study that reported at least one major medical error during the previous three months. Physicians are also asked to rank safety levels in hospitals or clinics where they work using a standardized questionnaire to assess the safety of the business unit.

“After finding out that the burned doctors were adjusting for expertise, working hours, fatigue and safety at work, we found that they were more than twice as big as self-reported medical errors,” Tawfik said. “We also found that the low security ratings in the business units are related to three to four times the likelihood of medical errors.”

“This is both the burnout level as well as the safety features of the business unit, which are independently associated with the risk of error,” Shanafelt says.
The burnout of doctors has become a national epidemic and many researchers have reported that, according to the authors, about half of all doctors are experiencing symptoms such as exhaustion, cynicism and diminished efficacy. The new study shows that physician exhaustion also affects care quality, patient safety, turnover rates and patient satisfaction.

“Today, most organizations are investing significant resources to increase security at every business unit and have a system-level approach. Shanafelt paid little attention to system-level factors leading to exhaustion in physicians and nurses. “We need a holistic, system-based approach to addressing the outbreak of burnout among providers of healthcare, if we really will create a high-quality healthcare system that we will do.”

The study also showed that medical error rates tripled in medical work units, and that physicians working on this unit showed a high level of burnout. Tawfik suggests that this may be the cause of a greater medical error than an unhealthy security environment.

“Until recently, if current thinking and medical errors appeared, we had to fix workplace safety with things like checklists and better teamwork,” Tawfik said. “This study shows that this is probably insufficient. We need a bi-directional approach to reduce medical malpractice, which also addresses physician exhaustion. “

The Effect of Physicians
In addition to the effects on patients, both errors and burnout can lead to serious personal consequences for physicians. “We also know from our previous work that both burnout and medical errors doubled the risk of suicidal thoughts among doctors independently,” Shanafelt said. “This contributes to a higher mortality risk among physicians than other professionals.”

Researchers at Jochen Profit and Mayo Clinic, professor of pediatrics at Stanford, also contributed to the study.

This work was supported by the National Institutes of Health, the Jackson Vaughan Critical Care Research Fund, the Mayo Clinic Program at the Doctor Well-Being and the Mayo Clinic Program at the American Medical Association and the Doctor Well-Being.

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