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Improving quality and safety in the hospital: The link between organisational culture, burnout, and quality of care

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Preventing physician burnout

An EU-funded project studied the link between hospital culture and physician burnout. Its work provided data and strategies for preventing burnout and improving patient care.

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The project ORCAB, involving 10 partners from nine countries, aimed to benchmark the organisational factors influencing the well-being of health professionals, quality of hospital care and patient safety. A multi-centre study, partners hailed from Bulgaria, Croatia, the former Yugoslav Republic of Macedonia, Greece, Ireland, Portugal, Romania, Turkey and the United Kingdom. ORCAB profiled the specific factors of hospital organisational culture that increase burnout among physicians, and monitored physician burnout and its association with quality of hospital care. The team then identified appropriate bottom-up solutions to these problems and developed a network for stakeholders to communicate about interventions to improve the quality of care. The project succeeded in meeting many of its goals. ORCAB built a website as an ongoing resource for stakeholders, providing guidance on how to reduce job burnout. The team also completed 10 systematic reviews that provided evidence-based data on these issues, and identified successful interventions. Other accomplishments include country-by-country reports on the targeted concerns in rarely studied countries. Although interventions were not developed for these countries, ORCAB did complete case studies based on qualitative and quantitative data. These case studies may be used as the basis for interventions in hospitals. ORCAB also identified three gaps in the assessment of organisational culture, quality of care and medical error. To fill these gaps, the project developed three scales to measure these variables. These tools have already contributed greatly to the field. Finally, a European network of hospitals has been established to further disseminate project findings. Through its work, ORCAB has already improved the working conditions of more than 3 000 health care professionals. With plans in place for providing consultation to clinics and hospitals interested in change, ORCAB hopes to bring about further reductions in physician burnout and improve patient care.


Physician burnout, hospital culture, patient care, hospital care, medical error

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