Association between physician burnout and patient safety: study protocol for an overview of systematic reviews and meta-analyses.

INTRODUCTION

Burnout, a disorder caused by chronic stress at work, involves emotional exhaustion, depersonalisation and reduced professional efficacy. The prevalence of burnout appears to be high among physicians worldwide. Burnout may affect different dimensions of healthcare, such as patient safety. Several systematic reviews and meta-analyses have examined the relationship between physician burnout and quality of care, although with some controversial results. To our knowledge, no overview of systematic reviews and meta-analyses has been conducted, specifically evaluating physician burnout, patient safety and other relevant aspects of quality of care. The main objective of this study will be to evaluate the available evidence of the association between physician burnout and patient safety.

METHODS AND ANALYSIS

An overview of systematic reviews and meta-analyses will be carried out. Systematic reviews with or without meta-analyses assessing the relationship between burnout in physicians and quality of care will be included. The primary outcome will be patient safety (ie, the occurrence of any adverse event related to healthcare which could have resulted, or did result, in unnecessary harm to patients). Secondary outcomes will be patient satisfaction and professionalism. Literature searches will be conducted (from their inception onwards) in PubMed/MEDLINE, EMBASE and Cochrane Database of Systematic Reviews. Two researchers will select studies that meet the predefined eligibility criteria and proceed to extract information from each included study. The methodological characteristics, measures of association and qualitative conclusions of the reviews will be assessed. The methodological quality of each review will also be analysed using the AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) tool. A descriptive synthesis will be carried out using evidence tables and graphs.

ETHICS AND DISSEMINATION

The proposed research mainly involves the analysis of existing studies, approval from a research ethics committee is not required. This overview of systematic reviews will help to gain a better understanding of the association between physician burnout and patient safety. Our findings could support future research, recommendations and policies in this area. We plan to publish the full study in a peer-reviewed journal.

REGISTRATION OF THE PROTOCOL

Open Science Framework: https://osf.io/wr73u/.