National Healthcare Quality and Disparities Report
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ÂÜÀòÊÓÆµResearch Studies Date
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- Burnout (8)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (1)
- Elderly (1)
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ÂÜÀòÊÓÆµResearch Studies
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Research Studies is a compilation of published research articles funded by ÂÜÀòÊÓÆµor authored by ÂÜÀòÊÓÆµresearchers.
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1 to 11 of 11 Research Studies DisplayedQuigley DD, Slaughter ME, Qureshi N
Associations of primary care provider burnout with quality improvement, patient experience measurement, clinic culture, and job satisfaction.
This study examined the association between provider burnout and perspectives on quality improvement (QI), patient experience, clinic culture, and job satisfaction among providers at Federally Qualified Health Centers (FQHCs). A cross-sectional survey of 74 providers revealed that 30% reported burnout. Key findings indicated that supportive leadership and lower patient care pressures were linked to reduced burnout. The study suggests fostering provider-team relationships and QI discussions may mitigate burnout, highlighting the need for further research on effective leadership strategies.
AHRQ-funded; HS025920; HS029321.
Citation: Quigley DD, Slaughter ME, Qureshi N .
Associations of primary care provider burnout with quality improvement, patient experience measurement, clinic culture, and job satisfaction.
J Gen Intern Med 2024 Jul; 39(9):1567-74. doi: 10.1007/s11606-024-08633-w..
Keywords: Primary Care, Burnout, Quality Improvement, Patient Experience, Quality of Care, Provider: Clinician
Quigley DD, Slaughter ME, Qureshi N
Associations of pediatric nurse burnout with involvement in quality improvement.
The purpose of this study was to explore the relationships of inpatient pediatric nurse burnout with their perceptions on the importance of quality at the hospital, and with patient experience measurement, quality improvement (QI), unit culture, and staffing. The researchers implemented a cross-sectional study at an urban children's hospital and surveyed pediatric nurses about their perceptions including the Maslach Burnout Inventory. The study found that 27% of pediatric nurses reported burnout. Nurses who possessed greater confidence in patient experience measurement, received frequent patient experience performance reports, felt included in QI, and experienced QI efforts as integrated into patient care reported not being burned out when compared to those reporting burnout. Higher levels of open communication among nurses and unit-level teamwork were also related with lack of burnout, and a higher QI workload was related with burnout.
AHRQ-funded; HS025920.
Citation: Quigley DD, Slaughter ME, Qureshi N .
Associations of pediatric nurse burnout with involvement in quality improvement.
J Pediatr Nurs 2023 May-Jun; 70:e9-e16. doi: 10.1016/j.pedn.2022.11.001..
Keywords: Children/Adolescents, Burnout, Provider: Nurse, Quality Improvement, Quality of Care
Abraham CM, Zheng K, Norful AA
Primary care nurse practitioner burnout and perceptions of quality of care.
Researchers investigated the relationship between primary care nurse practitioner (NP) burnout on perceptions of care quality and if the practice environment moderated the relationship between burnout and care quality. This was a secondary analysis of cross-sectional survey data from 396 NPs; the practice environment was measured using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. The researchers found that burnout was related to lower perceptions of care quality but favorable environments were related to higher perceptions of quality.
AHRQ-funded; HS027290.
Citation: Abraham CM, Zheng K, Norful AA .
Primary care nurse practitioner burnout and perceptions of quality of care.
Nurs Forum 2021 Jul;56(3):550-59. doi: 10.1111/nuf.12579..
Keywords: Burnout, Provider: Nurse, Primary Care, Quality of Care
Willard-Grace R, Knox M, Huang B
Primary care clinician burnout and engagement association with clinical quality and patient experience.
Burnout and engagement are commonly conceptualized as opposite ends of a spectrum, and there is concern that high clinician burnout and lack of engagement may adversely impact patient care. In this study, the investigators matched self-reported data on burnout and engagement for 182 primary care clinicians with data on clinical quality (cancer screenings, hypertension and diabetes control) and patient experience (Clinician and Group Survey-Consumer Assessment of Healthcare Providers and Systems [CG-CAHPS] communication scores, overall rating, and likelihood to recommend the clinic).
AHRQ-funded; HS026067.
Citation: Willard-Grace R, Knox M, Huang B .
Primary care clinician burnout and engagement association with clinical quality and patient experience.
J Am Board Fam Med 2021 May-Jun;34(3):542-52. doi: 10.3122/jabfm.2021.03.200515..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Burnout, Patient Experience, Patient and Family Engagement, Provider: Clinician, Provider: Physician, Quality of Care, Provider: Nurse, Provider: Health Personnel
Co Z, Holmgren AJ, Classen DC
The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
This study evaluated the overall performance of hospitals that used the Computerized Physician Order Entry Evaluation Tool in 2017 and 2018 and compared performances for fatal orders and nuisance orders each year. The authors evaluated 1599 hospitals that took the test by using their overall percentage scores along with the percentage of fatal orders appropriately alerted on and the percentage of nuisance orders incorrectly alerted on. Overall hospital scores improved from 58.1% in 2017 to 66.2% in 2018. Fatal order performance improved slightly from 78.8% to 83.0%, but there no very little change in nuisance order performance (89.0% to 89.7%). Conclusions were that perhaps hospitals are not targeting the deadliest orders first and some hospitals may be achieving higher scores by over-alerting. This has the potential to cause clinician burnout and even worsen patient safety.
AHRQ-funded; HS023696.
Citation: Co Z, Holmgren AJ, Classen DC .
The tradeoffs between safety and alert fatigue: data from a national evaluation of hospital medication-related clinical decision support.
J Am Med Inform Assoc 2020 Aug;27(8):1252-58. doi: 10.1093/jamia/ocaa098..
Keywords: Medication: Safety, Medication, Patient Safety, Clinical Decision Support (CDS), Shared Decision Making, Burnout, Hospitals, Health Information Technology (HIT), Quality of Care
White EM, Aiken LH, Sloane DM
Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction.
The objective of this cross-sectional study was to examine the relationships between work environment, care quality, registered nurse (RN) burnout, and job dissatisfaction in nursing homes. In this study, the investigators linked 2015 RN4CAST-US nurse survey data with LTCfocus and Nursing Home Compare. They indicate that their results suggest that the work environment is an important area to target for interventions to improve care quality and nurse retention in nursing homes.
AHRQ-funded; HS000011.
Citation: White EM, Aiken LH, Sloane DM .
Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction.
Geriatr Nurs 2020 Mar-Apr;41(2):158-64. doi: 10.1016/j.gerinurse.2019.08.007..
Keywords: Elderly, Nursing Homes, Burnout, Provider: Nurse, Provider, Quality of Care, Provider Performance
Hung DY, Harrison MI, Liang SY
ÂÜÀòÊÓÆµAuthor: Harrison MI
Contextual conditions and performance improvement in primary care.
This study examined organizational features of primary care clinics that had gone through Lean redesigns and had experienced the greatest performance improvements. They surveyed 1333 physicians and staff in 43 primary care clinics across a large primary care system. They found that clinics with prior experience with quality improvement had the highest increases in efficiency. Clinics reporting the highest levels of burnout and work stress before the redesign also made efficiency gains. Physician productivity gains was associated with a history of change, staff participation and leadership support. The greatest improvements in patient satisfaction occurred where there was the lowest stress levels with highest levels of teamwork, staff engagement and leadership support.
AHRQ-authored; AHRQ-funded; 2902010000221.
Citation: Hung DY, Harrison MI, Liang SY .
Contextual conditions and performance improvement in primary care.
Qual Manag Health Care 2019 Apr/Jun;28(2):70-77. doi: 10.1097/qmh.0000000000000198..
Keywords: Organizational Change, Healthcare Delivery, Primary Care, Provider Performance, Quality Improvement, Quality of Care, Workflow
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
Dyrbye LN, Shanafelt TD, Sinsky CA
ÂÜÀòÊÓÆµAuthor: Meyers D
https://nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care
Burnout among health care professionals: a call to explore and address this underrecognized threat to safe, high-quality care.
The high prevalence of burnout among health care professionals is cause for concern because it appears to be affecting quality, safety, and health care system performance. Efforts are needed to address this growing problem. Progress will require methodologically sound studies, adequate funding, and collaborative efforts. The authors hope that research sponsors, institutions, clinician organizations, researchers, clinicians, and patients join in supporting enhanced research efforts focused on these topics.
AHRQ-authored.
Citation: Dyrbye LN, Shanafelt TD, Sinsky CA .
NAM Perspectives 2017 Jul 5.
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Keywords: Quality of Care, Provider: Health Personnel, Patient Safety, Workforce
Rabatin J, Williams E, Baier Manwell L
Predictors and outcomes of burnout in primary care physicians.
This study assessed relationships between primary care work conditions, physician burnout, quality of care, and medical errors. It found that burnout is highly associated with adverse work conditions and a greater intention to leave the practice, but not with adverse patient outcomes. Care quality thus appears to be preserved at great personal cost to primary care physicians.
AHRQ-funded; HS011955.
Citation: Rabatin J, Williams E, Baier Manwell L .
Predictors and outcomes of burnout in primary care physicians.
J Prim Care Community Health 2016 Jan;7(1):41-3. doi: 10.1177/2150131915607799.
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Keywords: Provider: Health Personnel, Primary Care, Medical Errors, Patient Safety, Quality of Care
Linzer M, Poplau S, Grossman E
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
This study aimed to assess if improvements in work conditions reduce clinician stress and burnout. It found that burnout was more likely to improve with workflow interventions and with targeted QI projects than in controls. Also, interventions in communication or workflow led to greater improvements in clinician satisfaction.
AHRQ-funded; HS018160.
Citation: Linzer M, Poplau S, Grossman E .
A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: results from the Healthy Work Place (HWP) Study.
J Gen Intern Med 2015 Aug;30(8):1105-11. doi: 10.1007/s11606-015-3235-4..
Keywords: Burnout, Stress, Primary Care, Workflow, Quality Improvement, Quality of Care, Communication
