Burnout is a syndrome characterized by a high degree of emotional exhaustion and depersonalization, and a low sense of personal accomplishment at work. Depersonalization is thought to lead to poorer interactions with patients, serving as a threat to patient safety. A recent study linked patient mortality with the degree of emotional exhaustion a clinician experiences. This study suggested that emotionally exhausted clinicians reduce performance to focus on only the most necessary and pressing tasks. Burnout may also manifest in impaired executive function, attention, and memory, diminishing vigilance and cognitive function. These manifestations put patients at risk due to an increased probability of safety lapses.

Quality of Care

Clinician burnout is associated with poorer quality of care metrics and patient outcomes. Approximately 32% of depressed doctors said they were less engaged with patients and 29% acknowledged being less friendly. Medical students generally score higher in empathy than peers in other professions, but as they begin to experience more burnout, their levels of empathy drop.  Quality of interpersonal teamwork also deteriorates as emotional exhaustion increases, impacting clinician-rated patient safety. Promoting clinician well-being is an important step in managing teamwork and patient safety.

Patient Safety

The more emotional exhaustion and depersonalization a clinician experiences, the more likely they are to report a self-perceived major medical error. The same correlation is seen in trainees. Doctors experiencing depression have reported that their depression might cause them to make errors they wouldn’t ordinarily make, including ones that may harm patients.  Burnout is also linked with higher 30-day risk adjusted mortality rates, length of stay, medication error rate, and hospital infection rates. Stress levels in hospital employees have also been shown to correlate with the number of hospital malpractice suits. While there is clear evidence to suggest a link between clinician burnout and patient safety outcomes, more research is needed to understand the nature of this relationship.