Impact of physician workload on burnout in the emergency department

ABSTRACT

Emergency medicine is one of the medical fields with the highest rates of physician burnout. Research demonstrates hospitalists believe increasing workloads contribute to decreases in patient safety and satisfaction, and increases in morbidity and mortality. Our objective was to identify if emergency physicians who believe workload impacts patient care also experience worse rates of burnout symptoms.

This two-phase study used an online survey with cross-sectional design distributed to emergency medicine physicians following the New Jersey American College of Emergency Physicians (NJ ACEP) Scientific Assembly in May 2016 and members of the ACEP Well-Being Committee and Wellness Section in December 2016.

Respondents felt the greatest workload burdens by being ‘…unable to fully discuss treatment options or answer questions of a patient or family member’ or leading to ‘Delay in admitting or discharging patients.’ Excessive workload also contributed to respondents having to ‘Admit to hospital instead of discharge’ and resulted in ‘Worsened patient satisfaction.’ The ‘Emotional Exhaustion’ domain of the Maslach Burnout Inventory was the most highly affected by the perceived effects of workload on patient outcomes and ‘Personal Accomplishment’ was least affected. This research highlights the perception that workload contributing to patient harm may be associated with emergency medicine burnout.

KEYWORDS:

• Burnout
• workload
• emergency medicine
• physician burnout
• quality of care

Acknowledgments

The research team appreciates the support and participation of the American College of Emergency Physician’s Well-being Committee during the period of 2016-2017, the Rutgers University Research Council, and Pamela Ohman-Strickland and the Rutgers University Biostatistics and Epidemiology Services Center (RUBIES). We would like to also acknowledge the support of Henry J Michtalik, MD, MPH, Assistant Professor of Medicine at Johns Hopkins University School of Medicine; Grant Wei, MD, FAAEM, FACEP, Assistant Professor of Emergency Medicine at Rutgers-Robert Wood Johnson Medical School; Anna Petrova, MD, MPH, Professor of Pediatrics at Rutgers-Robert Wood Johnson Medical School; and Peter Melera, PhD, Professor of Medicine at Rutgers-Robert Wood Johnson Medical School.

Authors contribution

AGW contributed to study concept and design, acquisition of data, analysis and interpretation of data, drafting and critical revision of the manuscript and acquisition of funding.

JVM contributed to study concept and design, acquisition of data, analysis and interpretation of data, drafting and critical revision of the manuscript, and acquisition of funding.

JM contributed to acquisition of data, drafting the manuscript, and critical revision.

DAG contributed to study concept and design, analysis and interpretation of data, critical revision of the manuscript and statistical expertise.

RME contributed to study concept and design, acquisition of data, and acquisition of funding.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Investigation was supported with a grant from the Rutgers University Research Council, and manuscript production was supported with a grant from the Rutgers University Biostatistics and Epidemiology Services Center [RUBIES].