Taking Action Against Clinician Burnout A Systems Approach to Professional Well-Being (2019) / Chapter Skim
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3 Extent and Consequences of Clinician Burnout
3 Extent and Consequences of Clinician Burnout
Pages 63-80
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From page 63... ...
1 In this chapter, the committee describes various instruments used to measure the extent of burnout among clinicians and discusses the literature on the prevalence of burnout and its consequences for clinicians, health organizations (e.g., job retention and turnover) , and the quality of care.
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Other studies have used Oldenburg Burnout Inventory, the Copenhagen Burnout Inventory, or the Stanford Professional Fulfillment Index (Demerouti and Bakker, 2008; Dyrbye et al., 2018; Kristensen et al., 2005; Trockel et al., 2018)
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physicians, nurses, and dentists. The MBI, the Oldenburg Burnout Inventory, the Copenhagen Burnout Inventory, and the Stanford Professional Fulfillment Index instruments can be used across the health care professions broadly, including with physicians, nurses, advanced practice providers, social workers, and pharmacists.
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. In contrast, the items in the Oldenburg Burnout Inventory are assessed on a four-point agreement scale with options ranging from "totally disagree" to "totally agree," and items in the Copenhagen Burnout Inventory are rated on a frequency scale with options ranging from "never" to "always." Accordingly, the time interval over which the Oldenburg and Copenhagen Burnout Inventories can be used to measure change may be imprecise, and less is known about their ability to detect meaningful effect size from an intervention.
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Younger workers face a number of distinct challenges as they establish themselves in their career and deal with the complex interplay between personal and professional life as they begin relationships and care for children. Studies also demonstrate that women are at increased risk for burnout relative to their male colleagues after adjusting for other personal and professional factors (El-Ibiary et al., 2017; Lahoz and Mason, 1990; Shanafelt et al., 2012a,b, 2014a, 2015, 2016a; Templeton et al., 2019)
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Studies from outside health care have demonstrated that individual workers experiencing burnout are at an increased risk for cardiovascular disease (Appels and Schouten, 1991; Toker et al., 2012; Toppinen-Tanner et al., 2009) , as well as a host of other health consequences, including hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, and severe injuries (Salvagioni et al., 2017)
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. A dose–response relationship between burnout and suicidal ideation, independent of depression, has also been found in multiple studies (Dyrbye et al., 2008; Shanafelt et al., 2011; van der Heijden et al., 2008)
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Prospective longitudinal studies have demonstrated that individuals experiencing burnout are more likely to cut their professional work effort over the next 12 to 24 months (Shanafelt et al., 2016c)
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involving 42,473 physicians concluded that physician burnout was associated with an increased risk of patient safety incidents (OR [odds ratio] 1.96; 95% CI [confidence interval]
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. KEY FINDINGS Burnout is highly prevalent among health care clinicians and has important personal and professional consequences as well as negative effects
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In addition to the potentially tragic consequences for patients and clinicians, there are substantial economic costs to society and health care organizations. In aggregate, the facts make a compelling case for action to address health care professional burnout at the organization and societal levels.
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2008. The Oldenburg Burnout Inventory: A good alternative to measure burnout and engagement.
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2008. Nurse burnout and patient safety outcomes: Nurse safety perception versus reporting behavior.
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2016. An official Critical Care Societies Collaborative statement: Burnout syndrome in critical care healthcare profes sionals: A call for action.
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2018. Association between physician burnout and patient safety, professionalism, and patient satisfaction: A systematic review and meta-analysis.
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2016c. Longitudinal study evaluating the association between physician burnout and changes in professional work effort.
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2018. Physician burnout, well-being, and work unit safety grades in relationship to reported medical errors.
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2007. The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care: Results from the MEMO study.
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