Nav: Home

Psychologists analyze links between provider burnout, quality of care, patient safety

December 14, 2016

INDIANAPOLIS -- Health care provider burnout is known to have a relationship with both quality of care and patient safety. Psychologists from the School of Science at Indiana University-Purdue University Indianapolis conducted the first study to systematically, quantitatively analyze the links between health care provider burnout and health care quality and safety across medical disciplines.

The meta-analysis of 82 studies focused on links between burnout and quality as well as between burnout and safety. The studies involved almost 211,000 physicians, nurses and other clinicians.

The IUPUI scientists examined relationships between various aspects of provider burnout -- including emotional exhaustion, depersonalization and reduced personal accomplishment -- and the quality of care as perceived by providers and as perceived by patients (patient satisfaction). The scientists also examined the link between provider burnout and health care safety in the studies.

Provider self-reported quality ratings had a stronger correlation with burnout than did patient satisfaction. Similarly for safety concerns, provider burnout had a stronger relationship with perceptions of safety than with reported safety events including close or near misses; however, both relationships were still statistically significant.

"The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis" is published online ahead of print in the Journal of General Internal Medicine.

In their meta-analysis, the IUPUI scientists combined data from different types of studies conducted at numerous locations around the world with a variety of types of clinicians. Meta-analysis enables compression of large amounts of information, permitting analysis and dissemination of composite findings.

"We found a consistent relationship -- technically a medium effect size -- between higher levels of provider burnout and lower levels of both quality and safety," said study corresponding author Michelle Salyers, professor of psychology at IUPUI. She directs the school's clinical psychology program and is director of the Assertive Community Treatment Center of Indiana.

"These are important observations; however, we don't know the direction of the correlations," she said. "Does burnout cause care quality to diminish, or does poor quality cause clinician burnout? Or is there another factor causing both provider burnout and poor quality?"

Studies were weighted to account for the number of providers involved. The IUPUI scientists also rated the rigor of the studies to determine if the correlation between burnout and quality or between burnout and safety varied by study size and thoroughness of investigation. They found that it did not. They did, however, note roles for other predictors of quality and safety including organizational policies, staffing ratios and communication.

"While burnout is not the primary cause of poor quality health care nor the primary cause of patient safety issues, links between provider burnout and care quality and patient safety are real and should be recognized," said Salyers. "Our work provides a message for health care funders, policymakers and those who 'run' health care in a variety of settings -- clinic, hospital and system administrators -- that as they work to improve patient outcomes and safety, they should pay attention to the well-being of their workforce."
-end-
Authors of the JGIM study in addition to Salyers are IUPUI doctoral candidates Kelsey A. Bonfils, Lauren Luther, Ruth L. Firmin, Dominique A. White, Erin L. Adams and research scientist Angela L. Rollins. Rollins is also the associate director of the Veterans Administration Health Services Research and Development Center for Health Information and Communication, Richard L. Roudebush VA Medical Center in Indianapolis and the research director of the ACT Center of Indiana, a research and training center focused on evidence-based mental health practices that support recovery in adults with severe mental illnesses.

The School of Science at IUPUI is committed to excellence in teaching, research and service in the biological, physical, computational, behavioral and mathematical sciences. The school is dedicated to being a leading resource for interdisciplinary research and science education in support of Indiana's effort to expand and diversify its economy.

Indiana University-Purdue University Indianapolis School of Science

Related Health Care Articles:

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.
International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.
The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .
Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.
High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.
Health insurance changes, access to care by patients' mental health status
A research letter published by JAMA Psychiatry examined access to care before the Patient Protection and Affordable Care Act (ACA) and after the ACA for patients grouped by mental health status using a scale to assess mental illness in epidemiologic studies.
Medical expenditures rise in most categories except primary care physicians and home health care
This article was published in the July/August 2017 issue of Annals of Family Medicine research journal.
Care management program reduced health care costs in Partners Pioneer ACO
Pesearchers at Partners HealthCare published a study showing that Partners Pioneer ACO not only reduces spending growth, but does this by reducing avoidable hospitalizations for patients with elevated but modifiable risks.
Health care leaders predict patients will lose under President Trump's health care plans
According to a newly released NEJM Catalyst Insights Report, health care executives and industry insiders expect patients -- more than any other stakeholder -- to be the big losers of any comprehensive health care plan from the Trump administration.
The Lancet: The weaponisation of health care: Using people's need for health care as a weapon of war over six years of Syrian conflict
Marking six years since the start of the Syrian conflict (15 March), a study in The Lancet provides new estimates for the number of medical personnel killed: 814 from March 2011 to February 2017.
More Health Care News and Health Care Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#538 Nobels and Astrophysics
This week we start with this year's physics Nobel Prize awarded to Jim Peebles, Michel Mayor, and Didier Queloz and finish with a discussion of the Nobel Prizes as a way to award and highlight important science. Are they still relevant? When science breakthroughs are built on the backs of hundreds -- and sometimes thousands -- of people's hard work, how do you pick just three to highlight? Join host Rachelle Saunders and astrophysicist, author, and science communicator Ethan Siegel for their chat about astrophysics and Nobel Prizes.