Physician Burnout and Medical Errors: Exploring the Relationship, Cost, and Solutions.

Physician burnout has demonstrated risks to providers and patients through medical errors. This review aims to synthesize current data surrounding burnout and its impacts on quality to inform targeted interventions that benefit providers and patients. Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping review methodology was utilized to identify studies of quantitative metrics for burnout and medical errors. Three independent reviewers conducted screening, study selection, and data extraction. Of 1096 identified articles, 21 were analyzed. Overall, 80.9% used the Maslach Burnout Inventory to evaluate for burnout. Moreover, 71.4% used self-reported medical errors as their primary outcome measure. Other outcome measures included observed/identified clinical practice errors and medication errors. Ultimately, 14 of 21 studies found links between burnout and clinically significant errors. Significant associations exist between burnout and medical errors. Physician demographics, including psychological factors, well-being, and training level, modulate this relationship. Better metrics are necessary to quantify errors and their impacts on outcomes. These findings may inform novel interventions that target burnout and improve experiences.

The Evolving Curriculum in Quality Improvement and Patient Safety in Undergraduate and Graduate Medical Education: A Scoping Review.

Quality Improvement and Patient Safety (QIPS) has become an increasingly important area of focus within undergraduate and graduate medical education. A variety of different QIPS curriculums have been developed, but standardization and effectiveness of these curriculums is largely unknown. The authors conducted a scoping review to explore the status of undergraduate and graduate nondegree QIPS curriculum in the United States. A scoping review was performed using The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model as a guide. Two databases were screened from January 2019 to March 2022 to identify relevant articles. Forty-seven articles met eligibility criteria, with most articles (n = 38) focused on graduate medical education. Of those 38, 86.8% (33/38) were developed as curriculum specific to a particular specialty. The article highlights similarities and differences in structure, evaluation metrics, and outcomes, and subsequently offers insight into curriculum components that should help guide standardization of successful curriculum development moving forward.

An Update to "Understanding Ambulatory Care Practices in the Context of Patient Safety and Quality Improvement".

The aim of this article is to summarize and interpret the current literature on patient quality and safety measures in the ambulatory setting. The authors reviewed the MEDLINE database from 2016 to the present for articles on patient quality and safety measures in the ambulatory setting. The search was guided by the use of specific keywords and medical subject heading terms, including patient safety, ambulatory care, quality, measurements, medical errors, medication safety and electronic prescribing, safety culture, diagnostic error, team training, continuity, care coordination, simulation exercises, and patient-centered. Studying ambulatory quality and safety remains challenging because of the heterogeneity and complexity of the outpatient environment. This review shows that since 2016, very modest progress has been made in this critical area. Effective change in ambulatory quality and safety will require a prioritization and redoubling of efforts.