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Table 2 Quality of Care Outcomes

From: The relationship between resident burnout and safety-related and acceptability-related quality of healthcare: a systematic literature review

Author(s) Medical Errors (ME) Quality of Care (QoC) Communication/Attitudes
Beckman et al. (2012) [26]
USA
  Multivariate analysis outcome: Desirability as a physician (95% CI):
Burnout Yes/No:
Beta: 0.063 (−0.20, 0.08), p = 0.38
MBI-DP:
Beta: −0.0006 (−0.01, 0.01), p = 0.93
MBI-EE:
Beta: −0.0028 (−0.01, 0.004), p = 0.43
MBI-PA:
Beta: −0.0032 (−0.01, 0.01), p = 0.47
Multivariate analysis outcome: Effective Communication (95% CI):
Burnout Yes/No:
Beta: 0.3046 (0.10, 0.51), p < 0.01
MBI-DP:
Beta: 0.0239 (0.0066, 0.0412), p < 0.01
MBI-EE:
Beta: 0.0090 (0.0004, 0.0177), p = 0.05
MBI-PA:
Beta: 0.0020 (−0.01, 0.02), p = 0.81
Block et al. (2013) [30]
USA
Make errors due to fatigue:
High burnout: 88%
Medium burnout: 88%
Low burnout: 43%
Make errors due to workload:*
High burnout: 94%
Medium burnout: 76%
Low burnout: 67%
Forget to order med:
High burnout: 41%
Medium burnout: 18%
Low burnout: 14%
Forget to convey info:*
High burnout: 41%
Medium burnout: 35%
Low burnout: 14%
*Significant difference across tertiles (p < 0.05)
  
de Oliveira et al. (2013) [31]
USA
Significant differences between high burnout risk only vs low burnout for all items:
• I make mistakes without negative consequences to my patients
• I perform procedures without appropriate training
• I make mistakes with negative consequences to my patients
• I fall short in the quality of care I provide to my patients
• I do not have enough time or attention for my patients
• I have made medication errors involving the wrong drug or dose in the last year
• I do not monitor the patient in the operating room as closely as I should
  
Fahrenkopf et al. (2008) [25]
USA
Based on chart: Rates of error/resident month:
Burnout = 0.45 (0.20, 0.98)
No burnout = 0.53 (0.21, 1.33)
p = 0.4
Self-report: Made significant medical error due to sleep deprivation:
Burnout = 29%
No burnout = 10%
p = 0.05
Self-report: Mean number of errors over past month:
Burnout = 2.3
No burnout = 1.0
p = 0.02
  
Passalacqua and Segrin (2012) [28]
USA
   Correlation between patient-centered communication and burnout: r = −0.52, p < 0.001
Correlation between pre-post empathy decline and burnout: r = 0.28, p < 0.01
Prins et al. (2009) [32]
The Netherlands
Correlation between:
Moderate burnout and action/inexperience errors:
r = 0.18, p < 0.001
Severe burnout and inaction/inexperience errors:
r = 0.10, p < 0.001
Moderate burnout and errors due to lack of time:
r = 0.36, p < 0.001
Severe burnout and errors due to lack of time:
r = 0.23, p < 0.001
  
Shanafelt et al. (2002) [33]
USA
Odds Ratio of self-reported suboptimal patient care practiced monthly or weekly (95% CI):
Lowest DP reference group
2nd Quintile DP 0.78 (0.19, 3.13), p > 0.20
3rd Quintile DP1.51 (0.45, 5.12), p > 0.20
4th Quintile DP4.00 (1.05, 15.21), p = 0.04
Highest DP 4.96 (1.39, 17.71), p = 0.01
  
Toral-Villanueva et al. (2009) [34]
Mexico
Odds Ratios of self-reported suboptimal patient care practiced monthly (95% CI):
High EE: OR = 5.6 (2.9, 10.8)
High DP: OR = 4.4 (2.3, 8.5)
Low PA: OR = 2.1 (1.1, 4.0)
With burnout: OR = 5.5 (2.7, 11.2), p < 0.001
Odds Ratios of self-reported suboptimal patient care practiced weekly (95% CI):
High EE: OR = 8.3 (2.8, 24.3)
High DP: OR = 3.3 (1.2, 8.9)
With burnout: OR = 5.2 (1.6, 16.3), p = 0.005
  
West et al. (2006) [27]
USA
Association of burnout with a self-perceived major medical error in the following 3 months (95% CI): Controlling for depression and empathy:
DP: OR = 1.10 (1.04, 1.16), p = 0.001
EE: OR = 1.07 (1.03, 1.12), p < 0.001
PA: OR = 0.93 (0.88, 0.99), p = 0.02
  
West et al. (2009) [29]
USA
Association of burnout with a self-perceived major medical error in the following 3 months (95% CI): Controlling for fatigue:
DP: OR = 1.08 (1.04, 1.11), p < 0.001
EE: OR = 1.05 (1.03, 1.07), p < 0.001
PA: OR = 0.95 (0.92, 0.97), p < 0.001
Association of burnout with a self-perceived major medical error in the following 3 months (95% CI): Controlling for sleepiness:
DP: OR = 1.05 (0.98, 1.12), p = 0.15
EE: OR = 1.07 (1.03, 1.10), p < 0.001
PA: OR = 0.94 (0.89, 0.99), p = 0.02