Investigating the link between GP wellbeing and burnout upon patient safety

Abstract: Healthcare staff wellbeing and burnout have been fairly consistently found to be associated with patient safety outcomes (Hall et al. 2016; Salyers et al. 2016; Welp and Manser 2016). However, the research to date has been unable to determine a) whether burnout or wellbeing is more strongly linked to patient safety outcomes and b) whether these associations are evident within general practice. Furthermore, there is limited research on the temporal nature of these associations. This thesis aimed to fill these gaps in knowledge and additionally to determine whether specific occupational factors are associated with general practitioners’ levels of wellbeing, burnout, and safety outcomes. A multi-method approach was taken to address these aims, in addition to a systematic review. 

During Study 1, focus groups with GPs were conducted. This study identified various influencers of wellbeing, both internal and external to their practices, potential coping strategies (e.g. taking a break), and their understanding of how burnout and low wellbeing could impact on the quality and safety of patient care delivery. Study 2 used a cross-sectional survey design to quantitatively investigate the findings from the focus groups. This study found that practice support and number of hours spent on administrative work were associated with near misses and perceptions of acting as a safe practitioner, through the mediating roles of burnout and low wellbeing. Finally, study 3 used a daily diary method over seven days to determine whether daily fluctuations within general practitioners affected daily fluctuations in safety. This study identified that GPs’ levels of stress in the morning, as well as whether they had a break with a positive interaction during the day, had the strongest impact on safety perceptions and behaviours later that same day. 

In combination, these studies identified the importance of increasing support within the workplace to improve GP wellbeing, prevent and/or reduce burnout, and to potentially also see improvements in patient safety. 

Publications

1.        Systematic review: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159015

2.        Cross-sectional survey: http://eprints.whiterose.ac.uk/139989/
3.        Focus group study: http://eprints.whiterose.ac.uk/124516/3/MS%20for%20archiving.pdf
4.        Strategies to improve GP wellbeing https://academic.oup.com/fampra/article/35/4/511/4772572  
5.        PhD Thesis: http://etheses.whiterose.ac.uk/20450/