Care Provider Burnout, Adverse Outcomes, and Recommendations for Patient Safety Culture

Patient safety may be compromised by internal and external factors. Burnout among healthcare professionals is an important predictor of adverse patient outcomes. Understanding specific concerns among healthcare leadership, nurses, physicians, healthcare staff, and patients leads to a positive safety culture - a culture where mutual learning, productivity, and teamwork leads to patient safety, reduced adverse events, and enhanced care quality.

Geography: United States; Focus Area: Patient safety culture

The Importance of Patient Safety

Patient safety is directly related to adverse outcomes and compromises care quality. Adverse events are complications arising from patient care, due to errors that are not directly related to disease. Medical error is the third leading cause of mortality in the United States. Adverse events arising from errors are avoidable adverse events.

Burnout among healthcare providers poses a significant risk to patient safety. Physiological and psychological overload of the care team has a direct impact on patient outcomes. In the systematic review and meta analysis carried out by Garcia and team (2019), twenty one studies indicated that burnout was associated with worsening patient safety. Statistical analysis showed that the association between burnout and patient safety was more than 60%.

Factors that Compromise Patient Safety

Patient safety and burnout may be the result of several causal factors.

• Patient safety may be compromised by management error, system failure, inefficient processes, communication problems, teamwork, and psychological health of professionals (anxiety, depression, and burnout syndrome, depersonalization, low professional achievement, and emotional exhaustion).

• Healthcare staff may experience burnout as a result of long journeys, high workload, and compromised interpersonal relationships. Occupational stress and exhaustion among healthcare providers reduces effectiveness in care leading to adverse outcomes for patients and health services delivery.

• In physicians, imbalance between personal and professional lives was directly related to consequences of patient safety and care quality

• Hospital working conditions consist of human and systemic factors compromising patient safety - lack of professionalism, poor use of technology and tools, increased workload, hierarchical culture, messy workspace.

• Higher burnout rates were associated with lower teamwork, professional tiredness, and lower job satisfaction. Further, it was related to unfavorable outcomes for patients, patient and family complaints, and patient dissatisfaction.

• Depersonalization in healthcare professionals, resulting from burnout, caused them to be cold and distant towards patients, compromising care quality. In some studies, no significant association was found between the occurrence of disease, medical error, infection rates, and burnout.

• High workload determined professional fatigue. External factors affected burnout and negatively impacted patient safety, while internal factors did not.

• Nurse burnout was associated with increased risk of infection in patients.

• Personnel conflict was another factor cited by nurses that increased risk of burnout. Professional and emotional exhaustion had an undesirable effect on teamwork.

Promotion: Textbook of Patient Safety and Clinical Risk Management Paperback – Import, 16 December 2021 by Liam Donaldson (Editor), Riccardo Tartaglia (Editor), Susan Sheridan (Editor), Walter Ricciardi (Editor)

  

Recommendations for a Positive Safety Culture

Researchers proposed positive measures to improve patient safety and care quality in healthcare settings.

• Safety culture must be promoted, that consists of management support, open communication, professional suitability, teamwork and mutual learning, and promotes satisfaction and productivity.

• Leadership walks during the routine were found to be important in establishing relationships between health services leaders and health delivery professionals, to identify and solve problems related to patient safety. Effective interpersonal relationships reduced fatigue and exhaustion.

• The implementation of the TeamSTEPPS (Team Strategies and Tools to Improve Patient Safety and Performance) protocol improves the psychological safety of the care team and reduces burnout.

• Researchers recommend training on clinical practice guidelines, technology use, adverse events, training on infection prevention, improving working conditions, and providing emotional and psychological support to healthcare providers.

Therefore, burnout among healthcare providers may be given due consideration with the objective of implementing a systematic plan dealing in resolving the underlying issues compromising patient safety. Patient safety processes and protocols are integral to optimal care quality, lower infection rates, reduced medical error, and increased provider and patient satisfaction.

Promotion: Patient Safety Now: Applying Concepts, Theories, and Ideas for Creating a Safe Environment Paperback – Import, 4 October 2022 by Ralph R.B. Von Frese (Author)

   

Keywotrds

patient safety, physician burnout, teamwork, occupational stress, medical error, burnout syndrome, safety culture, professional tiredness, workload, psychological support, adverse events, emotional exhaustion

References

Garcia, C., Abreu, L., Ramos, J., Castro, C., Smiderle, F., Santos, J., & Bezerra, I. (2019). Influence of burnout on patient safety: Systematic review and meta-analysis. Medicina, 55(9), 553. https://doi.org/10.3390/medicina55090553