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The Relationship Between Professional Burnout and Quality and Safety in Healthcare: A Meta-Analysis
Open accessAbstract
Background Healthcare provider burnout is considered a factor in quality of care, yet little is known about the consistency and magnitude of this relationship. This meta-analysis examined relationships between provider burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and the quality (perceived quality, patient satisfaction) and safety of healthcare.Methods Publications were identified through targeted literature searches in Ovid MEDLINE, PsycINFO, Web of Science, CINAHL, and ProQuest Dissertations & Theses through March of 2015. Two coders extracted data to calculate effect sizes and potential moderators. We calculated Pearson's r for all independent relationships between burnout and quality measures, using a random effects model. Data were assessed for potential impact of study rigor, outliers, and publication bias.Results Eighty-two studies including 210,669 healthcare providers were included. Statistically significant negative relationships emerged between burnout and quality (r = -0.26, 95 % CI [-0.29, -0.23]) and safety (r = -0.23, 95 % CI [-0.28, -0.17]). In both cases, the negative relationship implied that greater burnout among healthcare providers was associated with poorer-quality healthcare and reduced safety for patients. Moderators for the quality relationship included dimension of burnout, unit of analysis, and quality data source. Moderators for the relationship between burnout and safety were safety indicator type, population, and country. Rigor of the study was not a significant moderator.Discussion This is the first study to systematically, quantitatively analyze the links between healthcare provider burnout and healthcare quality and safety across disciplines. Provider burnout shows consistent negative relationships with perceived quality (including patient satisfaction), quality indicators, and perceptions of safety. Though the effects are small to medium, the findings highlight the importance of effective burnout interventions for healthcare providers. Moderator analyses suggest contextual factors to consider for future study.
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“Burnout, characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, deteriorates mental health, staff retention [2], and patient safety [3].”
From The Work-life Check-ins randomized controlled trial: a leader-based adaptive, semi-structured burnout intervention in primary care clinics (2024) · cites this paper as [3]
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“Studies show that these issues also impact patient well-being and safety, leading to lower quality of care, reduced patient satisfaction, and higher rates of medical errors (2, 11).”
From Digital resilience interventions for healthcare workers: a systematic review (2025) · cites this paper as [11]
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- Stalker C, Harvey C. Professional Burnout: A Review of Theory, Research, and Prevention. Wilfrid Laurier University; 2002.
- National Collaborating Centre for Methods and Tools. Quality Assessment Tool for Quantitative Studies. Hamilton: McMaster University; 2008.
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Metadata
- Authors
- Salyers, M. P., Bonfils, K. A., Luther, L., Firmin, R. L., White, D. A., Adams, E. L., & Rollins, A. L.
- Affiliations
- Indiana University – Purdue University Indianapolis (US)
- Richard L. Roudebush VA Medical Center (US)
- Corresponding author
- Salyers, Michelle P.
- Venue
- Journal of General Internal Medicine
- Published
- 2016-10-26
- Volume
- 32
- Issue
- 4
- Pages
- 475-482
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC5377877
- OpenAlex
- W2543998875
- Cited by
- 843
- References
- 62
- Citations by year
- 2026: 75 · 2025: 115 · 2024: 104 · 2023: 113 · 2022: 128 · 2021: 128 · 2020: 75 · 2019: 51 · 2018: 31 · 2017: 21 · 2016: 1
- FWCI
- 6.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- Purdue University
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- professional burnout, emotional exhaustion, depersonalization, personal accomplishment, quality of care, patient safety, patient satisfaction, perceived quality of care, healthcare workers, burnout intervention
- MeSH terms
- Burnout, Professional, Clinical Competence, Health Personnel, Humans, Quality of Health Care, Patient Satisfaction, Patient Safety
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