Examining the link between burnout and medical error: A checklist approach

Background

The aim of this cross-sectional study was to develop an evidence-based systematic Medical Error Checklist (MEC) for self-reporting of medical errors. In addition the study examined the comparative influence of individual, structural, and organizational factors on the frequency of self-reported medical errors.

Research design

A three-step process was followed in order to develop three checklists, for internists, surgeons and pediatricians respectively. The Maslach Burnout Inventory (MBI), the Utrecht Work Engagement Scale (UWES) and the teamwork-subscale of the Hospital Survey on Patient Safety Culture (AHRQ) were used in order to measure physicians’ levels of burnout, job engagement and teamwork respectively. A total of 231 doctors working in a large teaching hospital in Greece participated in the study (response rate: 49.8%).

Results

Internal reliability coefficients were high for all three checklists. Gender, age, clinical experience, and working hours were not related to medical errors in any of the medical specialties. In surgeons, medical errors were negatively related to engagement (R² = 0.210, p = 0.004), while teamwork and depersonalization were the only predictive factors of frequency of medical errors, in both pediatricians and internists (R² = 0.306 p < 0.001).

Conclusions

The Medical Error Checklists developed in this study advance the study of medical errors by proposing a comprehensive, valid and reliable self-assessment tool. The results highlight the importance of hospital organizational factors in preventing medical errors.