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Cited by 353Healthcare professionals’ stress and burnoutStress and Burnout ResearchOccupational Health and Burnout

Emotional exhaustion and workload predict clinician-rated and objective patient safety

Open access
Welp, Annalena, Meier, Laurenz L., Manser, Tanja·2015·Frontiers in Psychology
DOI 10.3389/fpsyg.2014.01573PMC PMC4302790
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Abstract

AIMS: To investigate the role of clinician burnout, demographic, and organizational characteristics in predicting subjective and objective indicators of patient safety. BACKGROUND: Maintaining clinician health and ensuring safe patient care are important goals for hospitals. While these goals are not independent from each other, the interplay between clinician psychological health, demographic and organizational variables, and objective patient safety indicators is poorly understood. The present study addresses this gap. METHOD: Participants were 1425 physicians and nurses working in intensive care. Regression analysis (multilevel) was used to investigate the effect of burnout as an indicator of psychological health, demographic (e.g., professional role and experience) and organizational (e.g., workload, predictability) characteristics on standardized mortality ratios, length of stay and clinician-rated patient safety. RESULTS: Clinician-rated patient safety was associated with burnout, trainee status, and professional role. Mortality was predicted by emotional exhaustion. Length of stay was predicted by workload. Contrary to our expectations, burnout did not predict length of stay, and workload and predictability did not predict standardized mortality ratios. CONCLUSION: At least in the short-term, clinicians seem to be able to maintain safety despite high workload and low predictability. Nevertheless, burnout poses a safety risk. Subjectively, burnt-out clinicians rated safety lower, and objectively, units with high emotional exhaustion had higher standardized mortality ratios. In summary, our results indicate that clinician psychological health and patient safety could be managed simultaneously. Further research needs to establish causal relationships between these variables and support to the development of managerial guidelines to ensure clinicians' psychological health and patients' safety.

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  • Excessive workload contributes to clinicians' burnout, fatigue, and emotional exhaustion.

    “The excessive workload also contributes to clinicians’ burnout [29,30], fatigue [118,119], and emotional exhaustion [120,121].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [121]

    This citation is attached to emotional exhaustion, not the separately cited claims about burnout and fatigue. The Introduction (Burnout; page unavailable) describes emotional exhaustion as the core dimension of burnout and identifies time pressure as a stressor from which burnout can develop. It says demanding ICU work may exhaust clinicians’ resources, but does not establish that excessive workload causes emotional exhaustion; the citing sentence states that contribution without the paper’s qualification. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • Incorporating mental workload measurements into existing practices can better reflect realistic clinician-related outcomes, such as performance and patient care quality, and help establish standards to prevent burnout and errors.

    “This approach can better reflect realistic clinician-related outcomes, such as performance and patient care quality, and help establish standards to prevent burnout and errors [121].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [121]

    The Introduction describes a quantitative workload measure and the use of both subjective and objective patient-safety indicators. Practical Implications links burnout prevention and workload control to patient safety. But the paper does not show that incorporating mental-workload measurements into existing practices better reflects clinician performance or establishes standards to prevent errors; the Discussion calls for further research to develop guidance. Page numbers are unavailable in our copy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Authors
Welp, A., Meier, L. L., & Manser, T.
Affiliations
  • University of Fribourg (CH)
  • University Hospital Bonn (DE)
Corresponding author
Welp, Annalena
ORCID
Venue
Frontiers in Psychology
Publisher
Frontiers Media SA
Published
2015-01-22
Volume
5
Pages
1573-1573
ISSN
1664-1078 (ISSN-L)
DOI
10.3389/fpsyg.2014.01573
PMC
PMC4302790
OpenAlex
W2145351877
Cited by
353
References
91
Citations by year
2026: 19 · 2025: 22 · 2024: 34 · 2023: 38 · 2022: 39 · 2021: 66 · 2020: 42 · 2019: 38 · 2018: 28 · 2017: 15 · 2016: 6 · 2015: 5
FWCI
32.91
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Psychology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • National Science Foundation
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (128616)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
Keywords
clinician burnout, emotional exhaustion, workload, patient safety, intensive care unit, standardized mortality ratio, length of hospital stay, predictability, professional roles, organizational characteristics

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