Deciphering the Relationship Between Health Care Provider Burnout and Quality of Care
Authors: Carolyn S. Dewa, Karen Nieuwenhuijsen, Jeffrey S. Hoch
Journal: Annals of Internal Medicine (2019)

Editorials15 October 2019Deciphering the Relationship Between Health Care Provider Burnout and Quality of CareCarolyn S. Dewa, MPH, PhD, Karen Nieuwenhuijsen, PhD, and Jeffrey S. Hoch, PhDCarolyn S. Dewa, MPH, PhDUniversity of California, Davis, Sacramento, California (C.S.D., J.S.H.)Search for more papers by this author, Karen Nieuwenhuijsen, PhDAmsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (K.N.)Search for more papers by this author, and Jeffrey S. Hoch, PhDUniversity of California, Davis, Sacramento, California (C.S.D., J.S.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-2760 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Tawfik and colleagues (1) have reported the results of a systematic review and meta-analysis of studies of the relationship between health care provider burnout and quality of care. Consistent with previous reviews, they found evidence of an association of higher burnout with lower quality, but they report very high heterogeneity among the included studies. They question the magnitude of the relationship and are concerned about reporting bias. We believe that this current analysis offers few new insights about this relationship. We highlight future approaches that might provide a better understanding of the interplay between clinician burnout and quality of care. ...References1. Tawfik DS, Scheid A, Profit J, et al. Evidence relating health care provider burnout and quality of care. A systematic review and meta-analysis. Ann Intern Med. 2019;171:555-67. doi:10.7326/M19-1152 LinkGoogle Scholar2. Dewa CS, Loong D, Bonato S, et al. The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: a systematic review. BMJ Open. 2017;7:e015141. [PMID: 28637730] doi:10.1136/bmjopen-2016-015141 CrossrefMedlineGoogle Scholar3. Maslach C, Jackson SE. The measurement of experienced burnout. Journal of Organizational Behavior. 1981;2:99-113. CrossrefGoogle Scholar4. West CP, Dyrbye LN, Sloan JA, et al. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med. 2009;24:1318-21. [PMID: 19802645] doi:10.1007/s11606-009-1129-z CrossrefMedlineGoogle Scholar5. Grober ED, Bohnen JM. Defining medical error. Can J Surg. 2005;48:39-44. [PMID: 15757035] MedlineGoogle Scholar6. Dyrbye LN, Shanafelt TD, Sinsky PF, et al. Burnout Among Health Care Professionals: A Call to Explore and Address this Underrecognized Threat to Safe, High-Quality Care. NAM Perspectives Discussion Paper. Washington, DC: National Academy of Medicine; 2017. Google Scholar7. Fahrenkopf AM, Sectish TC, Barger LK, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008;336:488-91. [PMID: 18258931] doi:10.1136/bmj.39469.763218.BE CrossrefMedlineGoogle Scholar8. Aiken LH, Sermeus W, Van den Heede K, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ. 2012;344:e1717. [PMID: 22434089] doi:10.1136/bmj.e1717 CrossrefMedlineGoogle Scholar9. Oliveras I, Losilla JM, Vives J. Methodological quality is underrated in systematic reviews and meta-analyses in health psychology. J Clin Epidemiol. 2017;86:59-70. [PMID: 28499846] doi:10.1016/j.jclinepi.2017.05.002 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of California, Davis, Sacramento, California (C.S.D., J.S.H.)Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (K.N.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-2760.Corresponding Author: Carolyn S. Dewa, MPH, PhD, Department of Psychiatry and Behavioral Sciences, University of California, Davis, 2450 48th Street, Sacramento, CA 95817; e-mail, [email protected]edu.Current Author Addresses: Dr. Dewa: Department of Psychiatry and Behavioral Sciences, University of California, Davis, 2450 48th Street, Sacramento, CA 95817.Dr. Nieuwenhuijsen: Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, PO Box 22660, 1100 DE Amsterdam, the Netherlands.Dr. Hoch: Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, 2103 Stockton Boulevard, Sacramento, CA 95817.This article was published at Annals.org on 8 October 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEvidence Relating Health Care Provider Burnout and Quality of Care Daniel S. Tawfik , Annette Scheid , Jochen Profit , Tait Shanafelt , Mickey Trockel , Kathryn C. Adair , J. Bryan Sexton , and John P.A. Ioannidis Metrics 15 October 2019Volume 171, Issue 8Page: 589-590KeywordsDisclosureForecastingHealth careHealth care providersHealth care qualityPrevention, policy, and public healthPsychometricsPublic policyQuestionnairesSystematic reviews ePublished: 8 October 2019 Issue Published: 15 October 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...