Fulfillment, burnout and resilience in emergency medicine-Correlations and effects on patient and provider outcomes

• Published in: PloS one 2020-10, Vol.15 (10), p.e0240934
• Main Authors: Jyothindran, Revathi, d'Etienne, James P, Marcum, Kevin, Tijerina, Aubre, Graca, Clare, Knowles, Heidi, Chaudhari, Bharti R, Zenarosa, Nestor R, Wang, Hao
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Biology and Life Sciences; Burnout; Burnout, Professional - epidemiology; Burnout, Professional - psychology; Correlation; Demographic aspects; Demography; Domains; Emergency medical care; Emergency medical personnel; Emergency medical services; Emergency Medicine; Engineering and Technology; Female; Health aspects; Health Personnel - psychology; Humans; Job satisfaction; Logistic Models; Male; Markers; Medical errors; Medical Errors - psychology; Medical Errors - statistics & numerical data; Medicine and Health Sciences; Middle Aged; Patient Outcome Assessment; Patient satisfaction; People and Places; Personal Satisfaction; Physicians; Psychological aspects; Regression analysis; Research and Analysis Methods; Resilience; Resilience (Personality trait); Resilience, Psychological; Self Report; Social Sciences; Synergistic effect
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0240934

Healthcare provider wellness have been reported to correlate with patient care outcomes. It is not understood whether synergistic effects may exist between them. We aim to investigate three provider wellness markers and determine their associations with provider self-reported medical errors and intent-to-leave outcomes among Emergency Department (ED) providers. This is a multi-center retrospective study. Three wellness domains include professional fulfillment (PF), burnout (BO), and personal resilience (PR). Two outcomes measured as provider self-reported medical errors and provider intent-to-leave. Correlations between wellness markers and outcomes were analyzed. When adjusted for other confounders (provider demographics, provider experience, and operational environment), a multivariate logistic regression analysis was performed to further determine the interactions among these three domains on provider wellness affecting patient and provider related outcomes. Total 242 surveys were collected from providers at 16 different EDs. The median score of PF were 2.83 among physicians and 2.67 among APPs, BO were 1.00 (physicians) and 0.95 (APPs), and PR were 0.88 (physicians) and 0.81 (APPs). The median scores of self-reported medical errors were 1.50 (physicians) and 0.95 (APPs), and intent-to-leave were 1.00 (physicians and APPs). High correlations occurred among PF, BO, and PR. When analyzed together, high PF, low BO, and high PR functioned as a protective effect on provider intent-to-leave (adjusted odds ratios = 0.09, 95% CI 0.03-0.30). High correlations occurred among three provider wellness markers with no significant difference between physicians and APPs. Providers with high PR, low BO, and high PR tended to be more stable in their jobs.