National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Behavioral Health (3)
- (-) Burnout (20)
- Children/Adolescents (1)
- Clostridium difficile Infections (1)
- Critical Care (1)
- Depression (2)
- Education: Continuing Medical Education (3)
- Electronic Health Records (EHRs) (1)
- Healthcare-Associated Infections (HAIs) (1)
- Health Information Technology (HIT) (1)
- Hospitals (3)
- Infectious Diseases (1)
- Long-Term Care (1)
- Medical Errors (2)
- Nursing Homes (1)
- Organizational Change (1)
- Patient-Centered Healthcare (1)
- Patient Experience (1)
- Patient Safety (3)
- Primary Care (6)
- Primary Care: Models of Care (1)
- Provider (13)
- Provider: Clinician (3)
- Provider: Health Personnel (1)
- Provider: Nurse (5)
- Provider: Physician (11)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (1)
- Quality of Care (1)
- Social Stigma (1)
- Stress (4)
- Surgery (1)
- Teams (1)
- Training (1)
- Workflow (1)
- Workforce (4)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 20 of 20 Research Studies DisplayedHu YY, Ellis RJ, Hewitt DB
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
A cross-sectional national survey of general surgery residents, administered with the 2018 American Board of Surgery In-Training Examination, assessed mistreatment, burnout, and suicidal thoughts during the past year. The authors assessed the association of mistreatment with burnout and suicidal thoughts; they found that mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.
AHRQ-funded; HS000078.
Citation: Hu YY, Ellis RJ, Hewitt DB .
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
N Engl J Med 2019 Oct 31;381(18):1741-52. doi: 10.1056/NEJMsa1903759..
Keywords: Education: Continuing Medical Education, Burnout, Stress, Surgery, Provider: Physician, Provider, Training
Kelly LA, McHugh MD, Aiken LH
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
The goal of this study was to determine whether work environments, staffing, and nurse outcomes differ between Magnet and non-Magnet hospitals. Results demonstrated superior nurse work environments in Magnet hospitals compared with non-Magnet hospitals, with better work environments being associated with lower nurse job dissatisfaction and burnout. Three decades of evidence showing superior outcomes for Magnet hospitals place this organizational innovation into a class all of its own as best practice, deserving the attention of hospital leaders, nurses, and the public.
AHRQ-funded; HS017551.
Citation: Kelly LA, McHugh MD, Aiken LH .
Nurse Outcomes in Magnet(R) and non-magnet hospitals.
J Nurs Adm 2019 Oct;49(10S Suppl):S19-s24. doi: 10.1097/nna.0000000000000801..
Keywords: Burnout, Hospitals, Provider, Provider: Nurse, Workforce
White EM, Aiken LH, McHugh MD
Registered nurse burnout, job dissatisfaction, and missed care in nursing homes.
The purpose of this article was to examine the relationship between registered nurse (RN) burnout, job dissatisfaction, and missed care in nursing homes. The investigators concluded that missed nursing care due to inadequate time or resources is common in nursing homes and is associated with RN burnout and job dissatisfaction; they indicated that improved work environments with sufficient staff hold promise for improving care and nurse retention.
AHRQ-funded; HS000011.
Citation: White EM, Aiken LH, McHugh MD .
Registered nurse burnout, job dissatisfaction, and missed care in nursing homes.
J Am Geriatr Soc 2019 Oct;67(10):2065-71. doi: 10.1111/jgs.16051..
Keywords: Provider: Nurse, Provider, Burnout, Nursing Homes, Long-Term Care, Workforce
Kroth PJ, Morioka-Douglas N, Veres S
Association of electronic health record design and use factors with clinician stress and burnout.
The authors sought to determine which electronic health record (EHR) design and use factors are associated with clinician stress and burnout and to identify other sources that contribute to this problem. Surveying ambulatory primary care and subspecialty clinicians from 3 institutions, they found that, although EHR design and use factors are associated with clinician stress and burnout, other challenges, such as chaotic clinic atmospheres and workload control, explain considerably more of the variance in these adverse clinician outcomes.
AHRQ-funded; HS022065.
Citation: Kroth PJ, Morioka-Douglas N, Veres S .
Association of electronic health record design and use factors with clinician stress and burnout.
JAMA Netw Open 2019 Aug 2;2(8):e199609. doi: 10.1001/jamanetworkopen.2019.9609..
Keywords: Burnout, Stress, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider: Clinician, Provider: Physician, Provider: Nurse
Brunsberg KA, Landrigan CP, Garcia BM
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
The objective of this paper was to determine whether higher rates of medical errors were associated with positive screenings for depression or burnout among resident physicians. Results of this prospective cohort study showed that resident physicians with a positive depression screen were three times more likely than those who screened negative to make harmful errors, indicating the importance of determining what interventions might mitigate the patient safety risk.
AHRQ-funded; HS019456.
Citation: Brunsberg KA, Landrigan CP, Garcia BM .
Association of pediatric resident physician depression and burnout with harmful medical errors on inpatient services.
Acad Med 2019 Aug;94(8):1150-56. doi: 10.1097/acm.0000000000002778..
Keywords: Children/Adolescents, Provider: Physician, Provider, Medical Errors, Adverse Events, Burnout, Patient Safety, Depression, Behavioral Health
Barbash IJ, Pilewski JM, McVerry BJ
Closing the loop: engaging leaders and front-line physicians to promote physician wellness.
The authors describe their experience with linking buy-in from organizational leaders with a process of engaging frontline physicians to identify and drive changes designed to improve physician wellness in an academic pulmonary and critical care medicine division. They conclude that, with support from local leaders, empowered physicians can improve their work environments in ways that allow them to focus on the essential missions of academic medicine—discovery, teaching, and patient care.
AHRQ-funded; HS025455.
Citation: Barbash IJ, Pilewski JM, McVerry BJ .
Closing the loop: engaging leaders and front-line physicians to promote physician wellness.
Ann Am Thorac Soc 2019 Aug;16(8):970-73. doi: 10.1513/AnnalsATS.201812-866PS.
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Keywords: Burnout, Provider: Physician, Provider
Gupta K, Lisker S, Rivadeneira NA
Decisions and repercussions of second victim experiences for mothers in medicine (SAVE DR MoM).
Researchers characterized events contributing to the second-victim effect among a diverse sample of physician mothers, described the impact on both provider and patient, and sought to determine the association between experiencing a mistake and burnout. They found that physician mothers involved in errors experience negative outcomes and may be at increased risk for burnout. They recommended additional research focusing on strategies to mitigate burnout associated with the second victim effect, particularly among women physicians and those with family responsibilities.
AHRQ-funded; HS023558.
Citation: Gupta K, Lisker S, Rivadeneira NA .
Decisions and repercussions of second victim experiences for mothers in medicine (SAVE DR MoM).
BMJ Qual Saf 2019 Jul;28(7):564-73. doi: 10.1136/bmjqs-2018-008372..
Keywords: Adverse Events, Burnout, Medical Errors, Patient Safety, Provider: Physician
Hessels AJ, Kelly AM, Chen L
Impact of infectious exposures and outbreaks on nurse and infection preventionist workload.
Researchers evaluated workload increases reported by staff nurses and infection preventionists (IPs) in response to common exposures and outbreaks. Using surveys, they concluded that organisms that are easier to treat and more difficult to spread, such as scabies or lice, can contribute substantially to nursing workload. Additionally, three-quarters of the nurses and one-half of the IPs reported that C difficile adds more than one hour to their daily workload.
AHRQ-funded; HS024915.
Citation: Hessels AJ, Kelly AM, Chen L .
Impact of infectious exposures and outbreaks on nurse and infection preventionist workload.
Am J Infect Control 2019 Jun;47(6):623-27. doi: 10.1016/j.ajic.2019.02.007..
Keywords: Burnout, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Provider: Nurse, Public Health
Nocon RS, Fairchild PC, Gao Y
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
This study examined the impact of adopting the patient-centered medical home (PCMH) on clinicians and staff at primary care practices. A longitudinal study was done comparing baseline (201) and post-intervention (2013-2014) survey results. Five-hundred thirty-six providers and staff at baseline and 589 were surveyed post-intervention. Almost half of all clinics reported improved better job morale, job satisfaction, and freedom from burnout. However, there were some clinics that saw a decrease in the percentage of providers reporting high job satisfaction and freedom from burnout. Control clinics were not used in this study, so it is impossible to know if results were similar in non-PCMH primary care practices.
AHRQ-funded; HS000084.
Citation: Nocon RS, Fairchild PC, Gao Y .
Provider and staff morale, job satisfaction, and burnout over a 4-year medical home intervention.
J Gen Intern Med 2019 Jun;34(6):952-59. doi: 10.1007/s11606-019-04893-z..
Keywords: Burnout, Patient-Centered Healthcare, Primary Care, Primary Care: Models of Care, Provider, Provider: Clinician, Stress
Tawfik DS, Shanafelt TD, Dyrbye LN
Personal and professional factors associated with work-life integration among US physicians.
Poor work-life integration (WLI) occurs when career and personal responsibilities come in conflict and may contribute to the ongoing high rates of physician burnout. The characteristics associated with WLI are poorly understood. The objective of this study was to identify personal and professional factors associated with WLI in physicians and identify factors that modify the association between gender and WLI.
AHRQ-funded; HS027837.
Citation: Tawfik DS, Shanafelt TD, Dyrbye LN .
Personal and professional factors associated with work-life integration among US physicians.
JAMA Netw Open 2021 May;4(5):e2111575. doi: 10.1001/jamanetworkopen.2021.11575..
Keywords: Burnout, Provider: Physician, Provider
Dir AL, Saldana L, Chapman JE
Burnout and mental health stigma among juvenile probation officers: the moderating effect of participatory atmosphere.
This study examined the effects of job burnout on mental health stigma among juvenile probation offices (JPOs). Due to the high rate of mental health issues among juveniles in the justice system, there is a high burnout rate among JPOs.
AHRQ-funded; HS024296.
Citation: Dir AL, Saldana L, Chapman JE .
Burnout and mental health stigma among juvenile probation officers: the moderating effect of participatory atmosphere.
Adm Policy Ment Health 2019 Mar;46(2):167-74. doi: 10.1007/s10488-018-0902-x..
Keywords: Burnout, Behavioral Health, Social Stigma
Edwards ST, Marino M, Balasubramanian BA
Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices.
The purpose of this study was to examine the association between physician-, advanced practice clinician- and staff-reported burnout and specific structural, organizational, and contextual characteristics of smaller primary care practices. Results showed that burnout is prevalent among physicians, advanced practice clinicians, and staff in smaller primary care practices. Members of solo practices less commonly report burnout, while members of health system-owned practices and Federally Qualified Health Centers more commonly report burnout, suggesting that practice level autonomy may be a critical determinant.
AHRQ-funded; HS023940.
Citation: Edwards ST, Marino M, Balasubramanian BA .
Burnout among physicians, advanced practice clinicians and staff in smaller primary care practices.
J Gen Intern Med 2018 Dec;33(12):2138-46. doi: 10.1007/s11606-018-4679-0..
Keywords: Burnout, Primary Care, Provider: Physician, Provider: Clinician, Provider
Aiken LH, Sloane DM, Barnes H
Nurses' and patients' appraisals show patient safety in hospitals remains a concern.
This study analyzed if there is a positive correlation between improvements of work environments for nurses and improvements in patient safety. A total of 535 hospitals in four large states at two points in time between 2005 and 2016 were studied. Survey data showed an improvement of work environment with 21% of study hospitals, and 7% had worse scores. For the hospitals with improved work environments, patients and nurses both reported high scores for patient safety indicators. For work environments which deteriorated, favorable patient safety grades went down 21%.
AHRQ-funded; HS022406.
Citation: Aiken LH, Sloane DM, Barnes H .
Nurses' and patients' appraisals show patient safety in hospitals remains a concern.
Health Aff 2018 Nov;37(11):1744-51. doi: 10.1377/hlthaff.2018.0711..
Keywords: Burnout, Hospitals, Patient Experience, Patient Safety, Provider: Nurse, Quality of Care, Quality Improvement
Cofer KD, Hollis RH, Goss L
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
The purpose of this study was to evaluate whether burnout was associated with emotional intelligence and job performance in surgical residents. The investigators found that burnout was present in surgery residents and was associated with emotional intelligence. There was no association of burnout with United States Medical Licensing Examination scores, American Board of Surgery In-Training Exam percentile, or surgical milestones. The investigators suggested that traditional methods of assessing resident performance may not be capturing burnout and strategies to reduce burnout should consider targeting emotional intelligence.
AHRQ-funded; HS023009.
Citation: Cofer KD, Hollis RH, Goss L .
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
J Surg Educ 2018 Sep - Oct;75(5):1171-79. doi: 10.1016/j.jsurg.2018.01.021..
Keywords: Burnout, Education: Continuing Medical Education, Provider, Provider: Physician, Provider Performance
Simpkin AL, Khan A, West DC
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
This study examined how stress from uncertainty is related to resilience among medical residents and whether those attributes are related to depression and burnout. The investigators surveyed 86 residents in pediatric residency programs from 4 urban freestanding children’s hospitals in North America in 2015. They used the Physicians’ Reaction to Uncertainty Scale to measure stress from uncertainty, the 14-item Resilience Scale to measure uncertainty, the Harvard National Depression Scale for depression, and the Maslach Burnout Inventory for burnout. There was a response rate of 58.1%. Five residents met depression criteria, and 15 residents met the burnout criteria. Depressed and burned out residents both had higher mean levels of stress compared to residents who neither depressed nor burned out.
AHRQ-funded; HS022986.
Citation: Simpkin AL, Khan A, West DC .
Stress from uncertainty and resilience among depressed and burned out residents: a cross-sectional study.
Acad Pediatr 2018 Aug;18(6):698-704. doi: 10.1016/j.acap.2018.03.002..
Keywords: Burnout, Stress, Depression, Provider: Physician, Behavioral Health, Provider, Education: Continuing Medical Education, Hospitals
Blechter B, Jiang N, Cleland C
Correlates of burnout in small independent primary care practices in an urban setting.
Little is known about the prevalence and correlates of burnout among providers who work in small independent primary care practices (< 5 providers). The authors conducted a cross-sectional analysis by using data collected from 235 providers practicing in 174 small independent primary care practices in New York City. The burnout rate was relatively low among their sample of providers compared with previous surveys that focused primarily on larger practices.
AHRQ-funded; HS023922.
Citation: Blechter B, Jiang N, Cleland C .
Correlates of burnout in small independent primary care practices in an urban setting.
J Am Board Fam Med 2018 Jul-Aug;31(4):529-36. doi: 10.3122/jabfm.2018.04.170360..
Keywords: Burnout, Provider: Health Personnel, Primary Care
Costa DK, Moss M
The cost of caring: emotion, burnout, and psychological distress in critical care clinicians.
This paper comments on emotion, burnout, and psychological distress in critical care clinicians. It stresses that the current management approaches for burnout and other forms of psychological distress are insufficient and discusses possibilities for improvement.
AHRQ-funded; HS024552.
Citation: Costa DK, Moss M .
The cost of caring: emotion, burnout, and psychological distress in critical care clinicians.
Ann Am Thorac Soc 2018 Jul;15(7):787-90. doi: 10.1513/AnnalsATS.201804-269PS..
Keywords: Burnout, Critical Care, Provider, Workforce
Huber MT, Ham SA, Qayyum M
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
Investigators used an experimental vignette to test associations between physician demographics, salary, and working with exemplary colleagues on the likelihood of preferring a new job among burned out and non-burned out physicians in various specialties. They found that, among burned out physicians, the opportunity for better salary and colleagues made them more likely to prefer a new job compared to non-burned out physicians, with change in salary associated with the greatest difference. They recommended focusing on improving physician-colleague relationships to improve job retention.
AHRQ-funded; HS000078.
Citation: Huber MT, Ham SA, Qayyum M .
Association between job factors, burnout, and preference for a new job: a nationally representative physician survey.
J Gen Intern Med 2018 Jun;33(6):789-91. doi: 10.1007/s11606-018-4412-z..
Keywords: Burnout, Workforce, Provider: Physician, Provider
Hung DY, Harrison MI , Truong Q
AHRQ Author: Harrison MI
Experiences of primary care physicians and staff following lean workflow redesign.
The researchers examined the work experiences of primary care physicians and staff after implementing Lean-based workflow redesigns. They found that both physicians and nonphysician staff reported higher levels of engagement and teamwork after implementing redesigns. However, the subjects also experienced higher levels of burnout and perceptions of the workplace as stressful.
AHRQ-authored; AHRQ-funded; 290201000022I.
Citation: Hung DY, Harrison MI , Truong Q .
Experiences of primary care physicians and staff following lean workflow redesign.
BMC Health Serv Res 2018 Apr 10;18(1):274. doi: 10.1186/s12913-018-3062-5.
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Keywords: Primary Care, Workflow, Burnout, Organizational Change, Provider: Physician, Teams
Cuellar A, Krist AH, Nichols LM
Effect of practice ownership on work environment, learning culture, psychological safety, and burnout.
The researchers examined whether there are differences across practice ownership in self-reported work environment, a practice culture of learning, psychological safety, and burnout. They concluded that hospital ownership was associated with positive perceptions of practice work environment and lower burnout for staff relative to independent ownership, whereas clinicians in federally qualified health centers (FQHCs) perceive a more negative, less joyful work environment and burnout.
AHRQ-funded; HS023913.
Citation: Cuellar A, Krist AH, Nichols LM .
Effect of practice ownership on work environment, learning culture, psychological safety, and burnout.
Ann Fam Med 2018 Apr;16(Suppl 1):S44-s51. doi: 10.1370/afm.2198.
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Keywords: Primary Care, Burnout, Provider