Researchers evaluate hospital working conditions to promote improved patient care

Researchers at The University of Nottingham are part of a new pan-European research study examining whether working conditions in hospitals are contributing to doctor 'burnout' and putting patients' lives at risk.

The five-year project, funded with more than €2m from the European Union, will work with hospital doctors to identify issues within the workplace which affect their ability to practice medicine safely and effectively. In an example of groundbreaking 'action research' the academics will then directly collaborate with the healthcare professionals to develop strategies that could be used to improve organisational culture, reduce 'burnout' and, ultimately, improve patient care.

The Nottingham team is being led by Kavita Vedhara, professor of applied psychology in the University's Institute of Work, Health and Organisations.

Professor Vedhara said: "This project is attempting to uncover aspects of the hospital working environment which potentially may be psychologically toxic and we will be doing that by asking the healthcare professionals who deliver patient care within it every day.

"Issues could be organisational, such as having to work in multidisciplinary teams where individuals have their own quite different objectives, or they could be at a far more personal level, for example in coping with a lack of administrative support or handling strained working relationships.

"These are the types of issues which many of us are faced with in our own jobs on a daily basis. The difference with doctors — and why this research is of such great importance — is that errors they may make as a result have far greater significance. Human lives are in their hands."

The University of Nottingham is the only English partner to be involved in the study, which is being coordinated by Dr Efharris Panagapolou at the Medical School of Aristotle University in Thessaloniki, Greece, and involves researchers in a total of nine European countries.

In the initial stage of the study, the Nottingham team will be carrying out a systematic literature review to assess the gold standards currently available for measuring quality of care, 'burnout' and job contentment.

They will also be using student doctors to assess whether there is a direct link between emotional state and quality of clinical skills such as suturing.

In the second stage of the project the European researchers will be gathering information on quality of care and 'burnout' directly from doctors at hospitals around south and south-eastern Europe through small focus groups and a questionnaire based on the six key domains of patient care as set out by the Institute of Medicine — that patient care is patient-centred, safe, effective, efficient, timely and equitable.

Among the issues they hope to shed light on is how the issue of 'burnout' may differ in different European countries and the role that culture has to play.

The final stage of the project will be to identify the top factors that most commonly lead to 'burnout' in doctors and work with the same healthcare professionals in devising strategies to minimise their impact and reduce the risk to patient care.

Assessing the effectiveness of these interventions in reducing doctors' stress and maintaining patient safety and quality of care could form the basis for a further study in the future, the researchers say.