Hospital Work Conditions and the Mediation Role of Burnout: Residents and Practicing Physicians Reporting Adverse Events

Abstract

Mu’taman Jarrar,1,2 Mohammad Al-Bsheish,3,4 Waleed Albaker,5 Ibtihal Alsaad,2 Eiman Alkhalifa,2 Sara Alnufaili,2 Nour Almajed,2 Reem Alhawaj,2 Mohammad T Al-Hariri,6 Ahmed A Alsunni,6 Badr K Aldhmadi,7 Arwa Alumran8 1Medical Education Department, King Fahad Hospital of the University, Al-Khobar, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Health Management Department, Batterjee Medical College, Jeddah, Saudi Arabia; 4Al-Nadeem Governmental Hospital, Ministry of Health, Amman, Jordan; 5Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 6Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 7Department of Health Management, College of Public Health and Health Informatics, University of Ha’il, Ha’il, Saudi Arabia; 8Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Mu’taman Jarrar, Al-Khobar, 34445, Saudi Arabia, Tel [phone], Email [email protected]; [email protected] Mohammad Al-Bsheish, Jeddah, 21442, Saudi Arabia, Tel [phone], Email [email protected]: “Patient Safety” in everyday practices is a target of healthcare leaders, and adverse events reported by healthcare providers directly reflect patient safety in the health system. Recognising how residents and practising physicians rate adverse events concerning their work conditions and burnout must be explored.Objective: This study aims to explore the mediation effect of burnout dimensions (emotional exhaustion and burnout-interpersonal disengagement) between the effects of work conditions on perceived patient safety by exploring the adverse events that residents and practising physicians reported.Methods: A quantitative and cross-sectional study collected data from 249 residents and practising physicians in a huge teaching hospital and primary health care centre (PHC) in the Eastern Province of Saudi Arabia. Hayes Macro regression analysis was employed to evaluate the multiple mediation effect of burnout dimensions, with 5000 bootstrapping and a confidence interval (CI) of 95% for statistical inference and p≤ 0.05 for the significance level.Results: Leadership support (B= 0.39, t= 6.24, p< 0.001) and physician engagement (B=0.43, t=6.50, p< 0.001) were associated with a decreased rate of adverse events to patient safety, whereas workload (B=− 0.23, t=− 3.73, p< 0.001) was negatively associated with an increased rate of adverse events. Burnout was shown to mediate the relationship between the effects of physician’s leadership support (R2=0.26, F=27.50, p< 0.001), work engagement (R2=0.25, F=27.07, p< 0.001) and workload (R2=0.23, F=24.23, p< 0.001) on the rate of adverse events.Conclusion: This study provides insights into burnout dimensions and their consequences on patient safety indicators (ie, adverse events). Work conditions (ie, leadership support, physician engagement, and workload) directly affect the rate of adverse events and indirectly through mediators like burnout-emotional exhaustion and burnout-interpersonal disengagement.Keywords: leadership support, physician engagement, workload, burnout, adverse events, patient safety

Keywords

• leadership support
• physician engagement
• workload
• burnout
• adverse events
• patient safety