PDF(Pubmed)
Abstract：
To evaluate physician burnout, well-being, and work unit safety grades in relationship to perceived major medical errors.
From August 28, 2014, to October 6, 2014, we conducted a population-based survey of US physicians in active practice regarding burnout, fatigue, suicidal ideation, work unit safety grade, and recent medical errors. Multivariate logistic regression and mixed-effects hierarchical models evaluated the associations among burnout, well-being measures, work unit safety grades, and medical errors.
Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P<.001), fatigue (46.6% vs 31.2%; P<.001), and recent suicidal ideation (12.7% vs 5.8%; P<.001). In multivariate modeling, perceived errors were independently more likely to be reported by physicians with burnout (odds ratio [OR], 2.22; 95% CI, 1.79-2.76) or fatigue (OR, 1.38; 95% CI, 1.15-1.65) and those with incrementally worse work unit safety grades (OR, 1.70; 95% CI, 1.36-2.12; OR, 1.92; 95% CI, 1.48-2.49; OR, 3.12; 95% CI, 2.13-4.58; and OR, 4.37; 95% CI, 2.06-9.28 for grades of B, C, D, and F, respectively), adjusted for demographic and clinical characteristics.
In this large national study, physician burnout, fatigue, and work unit safety grades were independently associated with major medical errors. Interventions to reduce rates of medical errors must address both physician well-being and work unit safety.
From August 28, 2014, to October 6, 2014, we conducted a population-based survey of US physicians in active practice regarding burnout, fatigue, suicidal ideation, work unit safety grade, and recent medical errors. Multivariate logistic regression and mixed-effects hierarchical models evaluated the associations among burnout, well-being measures, work unit safety grades, and medical errors.
Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P<.001), fatigue (46.6% vs 31.2%; P<.001), and recent suicidal ideation (12.7% vs 5.8%; P<.001). In multivariate modeling, perceived errors were independently more likely to be reported by physicians with burnout (odds ratio [OR], 2.22; 95% CI, 1.79-2.76) or fatigue (OR, 1.38; 95% CI, 1.15-1.65) and those with incrementally worse work unit safety grades (OR, 1.70; 95% CI, 1.36-2.12; OR, 1.92; 95% CI, 1.48-2.49; OR, 3.12; 95% CI, 2.13-4.58; and OR, 4.37; 95% CI, 2.06-9.28 for grades of B, C, D, and F, respectively), adjusted for demographic and clinical characteristics.
In this large national study, physician burnout, fatigue, and work unit safety grades were independently associated with major medical errors. Interventions to reduce rates of medical errors must address both physician well-being and work unit safety.
摘要：
为了评估医生的倦怠，幸福,和工作单位安全等级与感知到的重大医疗错误有关。
从2014年8月28日至2014年10月6日，我们对美国积极执业的医生进行了一项基于人群的调查，疲劳,自杀意念,工作单位安全等级,和最近的医疗错误。多变量逻辑回归和混合效应分层模型评估了职业倦怠之间的关联，福祉措施，工作单位安全等级,医疗错误。
在积极实践中的6695名回应医生中，6586提供了有关感兴趣领域的信息：3574（54.3％）报告了倦怠的症状，2163（32.8%）报告过度疲劳，427(6.5%)报告最近有自杀意念，6563人中有255人(3.9%)报告其主要工作区域的患者安全等级较差或不合格，6586人中有691人(10.5%)报告前3个月发生重大医疗错误。报告错误的医生更有可能出现倦怠症状（77.6%vs51.5%；P<.001），疲劳（46.6%vs31.2%；P<.001），和最近的自杀意念（12.7%vs5.8%；P<.001）。在多变量建模中，感知到的错误更有可能由患有倦怠的医生报告(比值比[OR]，2.22；95%CI，1.79-2.76)或疲劳(OR，1.38;95%CI，1.15-1.65)和工作单位安全等级逐渐变差的人(OR，1.70；95%CI，1.36-2.12；OR，1.92；95%CI，1.48-2.49；OR，3.12；95%CI，2.13-4.58；和OR，4.37；95%CI，B级2.06-9.28，C,D,F,分别)，根据人口统计学和临床特征进行调整。
在这项全国性的大型研究中,医生倦怠,疲劳,和工作单位安全等级与重大医疗差错独立相关.减少医疗错误率的干预措施必须同时解决医师的福祉和工作单位的安全。
从2014年8月28日至2014年10月6日，我们对美国积极执业的医生进行了一项基于人群的调查，疲劳,自杀意念,工作单位安全等级,和最近的医疗错误。多变量逻辑回归和混合效应分层模型评估了职业倦怠之间的关联，福祉措施，工作单位安全等级,医疗错误。
在积极实践中的6695名回应医生中，6586提供了有关感兴趣领域的信息：3574（54.3％）报告了倦怠的症状，2163（32.8%）报告过度疲劳，427(6.5%)报告最近有自杀意念，6563人中有255人(3.9%)报告其主要工作区域的患者安全等级较差或不合格，6586人中有691人(10.5%)报告前3个月发生重大医疗错误。报告错误的医生更有可能出现倦怠症状（77.6%vs51.5%；P<.001），疲劳（46.6%vs31.2%；P<.001），和最近的自杀意念（12.7%vs5.8%；P<.001）。在多变量建模中，感知到的错误更有可能由患有倦怠的医生报告(比值比[OR]，2.22；95%CI，1.79-2.76)或疲劳(OR，1.38;95%CI，1.15-1.65)和工作单位安全等级逐渐变差的人(OR，1.70；95%CI，1.36-2.12；OR，1.92；95%CI，1.48-2.49；OR，3.12；95%CI，2.13-4.58；和OR，4.37；95%CI，B级2.06-9.28，C,D,F,分别)，根据人口统计学和临床特征进行调整。
在这项全国性的大型研究中,医生倦怠,疲劳,和工作单位安全等级与重大医疗差错独立相关.减少医疗错误率的干预措施必须同时解决医师的福祉和工作单位的安全。
