Professional Burnout in Contemporary Health Systems Through the Lens of Electronic Health
Main Article Content
Abstract
Burnout has sparked global interest, as numerous researchers have been involved in national studies regarding its symptoms. It is described as a form of prolonged, chronic, occupational stress that exceeds the limits of endurance or the individual's ability to cope with it. Its appearance is multifactorial and is directly related to the place and object of work and to demographic and other characteristics of the individual. People who experience professional burnout experience emotional exhaustion, depersonalization, and reduced personal fulfillment, all of which have an increased risk of medical errors. At the same time, the development of e-health has transformed health systems. While these new digital tools have been created to increase the efficiency, quality and safety of care, research has shown that misuse and overwork can exacerbate burnout. This article deals with the relationship between burnout and medical errors through the prism of e-health. Studying articles from the international literature, he analyzes the different theoretical models of burnout, analyzes the human factor in medical errors and evaluates the impact of digital health technologies. It focuses on the design of human-based health technologies to carry out the proper implementation of modern health systems in order to reduce burnout and patient safety. At the same time, it points out the importance of the well-being of health professionals as a determining factor in the quality of healthcare. Supportively, the happier the health workforce, the greater the safety of patients and the more the efficiency of the health system increases.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016). Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PLOS ONE, 11(7), e0159015.
https://doi.org/10.1371/journal.pone.0159015
II. Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & Andrade, S. M. de. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLOS ONE, 12(10),
e0185781. https://doi.org/10.1371/journal.pone.0185781
III. Karaferis, D., Aletras, V., & Niakas, D. (2022). Job satisfaction and associated factors in Greek public hospitals. Acta Bio-Medica : Atenei Parmensis, 93(5), e2022230.
https://doi.org/10.23750/abm.v93i5.13095
IV. Dimitris, Karaferis, Dimitra, Balaska, & Yannis, Pollalis. (2025). Digitalization and Artificial Intelligence as Motivators for Healthcare Professionals. Japan Journal of Research, 6(3). https://doi.org/10.33425/2690-8077.1170
V. Karaferis, D., Balaska, D., Konstantopoulou, D., & Pollalis, Y. (2025). Long-Term Economic Consequences of Artificial Intelligence Implementation in Healthcare Institutional Performance Management, Effectiveness, and Patient Outcomes-The Importance of Thorough Health Technology Assessment: A Systematic Review. Biomedical Journal of Scientific & Technical Research, 64(1).
https://doi.org/10.26717/BJSTR.2025.64.009977
VI. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job Burnout. Annual Review of Psychology, 52(1), 397–422.
https://doi.org/10.1146/annurev.psych.52.1.397
VII. West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: contributors, consequences and solutions. Journal of Internal Medicine, 283(6), 516–529.
https://doi.org/10.1111/joim.12752
VIII. Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive Leadership and Physician Well-being. Mayo Clinic Proceedings, 92(1), 129–146.
https://doi.org/10.1016/j.mayocp.2016.10.004
IX. Dimitris, K., Dimitra, B., & Yannis, P. (2025). Digitalization and Artificial Intelligence as Motivators for Healthcare Professionals. Japan Journal of Research, 6(3).
https://doi.org/10.33425/2690-8077.1170
X. Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99–113.
https://doi.org/10.1002/job.4030020205
XI. Shirom, A. (2003). Job-related burnout: A review. In Handbook of occupational health psychology. (pp. 245–264). American Psychological Association. https://doi.org/10.1037/10474-012
XII. Demerouti, E., Bakker, A. B., Nachreiner, F., & Schaufeli, W. B. (2001). The job demands-resources model of burnout. Journal of Applied Psychology, 86(3), 499–512.
https://doi.org/10.1037/0021-9010.86.3.499
XIII. Bakker, A. B., Demerouti, E., & Sanz-Vergel, A. I. (2014). Burnout and Work Engagement: The JD–R Approach. Annual Review of Organizational Psychology and Organizational Behavior, 1(1), 389–411.
https://doi.org/10.1146/annurev-orgpsych-031413-091235
XIV. Bakker, A. B., & de Vries, J. D. (2021). Job Demands–Resources theory and self-regulation: new explanations and remedies for job burnout. Anxiety, Stress, & Coping, 34(1), 1–21.
https://doi.org/10.1080/10615806.2020.1797695
XV. Freudenberger, H. J. (1974). Staff Burn‐Out. Journal of Social Issues, 30(1), 159–165.
https://doi.org/10.1111/j.1540-560.1974.tb00706.x
XVI. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job Burnout. Annual Review of Psychology, 52(1), 397–422.
https://doi.org/10.1146/annurev.psych.52.1.397
XVII. Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Organizational Behavior, 2(2), 99–113.
https://doi.org/10.1002/job.4030020205
XVIII. World Health Organization. (2019). Burn-out an occupational phenomenon: International Classification of Diseases (11th Revision).
Https://Icd.Who.Int/Browse11/l-m/En#/Http://Id.Who.Int/Icd/Entity/129180281.
XIX. Edú-Valsania, S., Laguía, A., & Moriano, J. A. (2022). Burnout: A Review of Theory and Measurement. International Journal of Environmental Research and Public Health, 19(3), 1780.
https://doi.org/10.3390/ijerph19031780
XX. Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. https://doi.org/10.1002/wps.20311
XXI. Edú-Valsania, S., Laguía, A., & Moriano, J. A. (2022). Burnout: A Review of Theory and Measurement. International Journal of Environmental Research and Public Health, 19(3), 1780. https://doi.org/10.3390/ijerph19031780
XXII. Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. https://doi.org/10.1002/wps.20311
XXIII. Piperac, P., Todorovic, J., Terzic-Supic, Z., Maksimovic, A., Karic, S., Pilipovic, F., & Soldatovic, I. (2021). The Validity and Reliability of the Copenhagen Burnout Inventory for Examination of Burnout among Preschool Teachers in Serbia. International Journal of Environmental Research and Public Health, 18(13), 6805.
https://doi.org/10.3390/ijerph18136805
XXIV. Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 19(3), 192–207.
https://doi.org/10.1080/02678370500297720
XXV. Tawfik, D. S., Profit, J., Morgenthaler, T. I., Satele, D. V., Sinsky, C. A., Dyrbye, L. N., Tutty, M. A., West, C. P., & Shanafelt, T. D. (2018). Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors. Mayo Clinic Proceedings, 93(11), 1571–1580.
https://doi.org/10.1016/j.mayocp.2018.05.014
XXVI. Panagioti, M., Geraghty, K., Johnson, J., Zhou, A., Panagopoulou, E., Chew-Graham, C., Peters, D., Hodkinson, A., Riley, R., & Esmail, A. (2018). Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction. JAMA Internal Medicine, 178(10), 1317.
https://doi.org/10.1001/jamainternmed.2018.3713
XXVII. Shanafelt, T. D., Balch, C. M., Bechamps, G., Russell, T., Dyrbye, L., Satele, D., Collicott, P., Novotny, P. J., Sloan, J., & Freischlag, J. (2010). Burnout and Medical Errors Among American Surgeons. Annals of Surgery, 251(6), 995–1000. https://doi.org/10.1097/SLA.0b013e3181bfdab3
XXVIII. West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016). Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet, 388(10057), 2272–2281. https://doi.org/10.1016/S0140-6736(16)31279-X
XXIX. Makary, M. A., & Daniel, M. (2016). Medical error—the third leading cause of death in the US. BMJ, i2139. https://doi.org/10.1136/bmj.i2139
XXX. Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 14–25.
https://doi.org/10.1016/j.apergo.2013.04.023
XXXI. Reason, J. (2000). Human error: models and management. BMJ, 320(7237), 768–770.
https://doi.org/10.1136/bmj.320.7237.768
XXXII. Donaldson, L. J., Kelley, E. T., Dhingra-Kumar, N., Kieny, M.-P., & Sheikh, A. (2017). Medication Without Harm: WHO’s Third Global Patient Safety Challenge. The Lancet, 389(10080), 1680–1681. https://doi.org/10.1016/S0140-6736(17)31047-4
XXXIII. Kohn, L. T. , C. J. M. , & D. M. S. (2000). To Err Is Human. National Academies Press.
XXXIV. Newman-Toker, D. E., Nassery, N., Schaffer, A. C., Yu-Moe, C. W., Clemens, G. D., Wang, Z., Zhu, Y., Saber Tehrani, A. S., Fanai, M., Hassoon, A., & Siegal, D. (2024). Burden of serious harms from diagnostic error in the USA. BMJ Quality & Safety, 33(2), 109–120. https://doi.org/10.1136/bmjqs-2021-014130
XXXV. Singh, H., Meyer, A. N. D., & Thomas, E. J. (2014). The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations. BMJ Quality & Safety, 23(9), 727–731.
https://doi.org/10.1136/bmjqs-2013-002627
XXXVI. Rosenstein, A. H., & O’Daniel, M. (2008). A Survey of the Impact of Disruptive Behaviors and Communication Defects on Patient Safety. The Joint Commission Journal on Quality and Patient Safety, 34(8), 464–471. https://doi.org/10.1016/S1553-7250(08)34058-6
XXXVII. Manias, E., Bucknall, T., Hughes, C., Jorm, C., & Woodward-Kron, R. (2019). Family involvement in managing medications of older patients across transitions of care: a systematic review. BMC Geriatrics, 19(1), 95.
https://doi.org/10.1186/s12877-019-1102-6
XXXVIII. Reason, J. (2000). Human error: models and management. BMJ, 320(7237), 768–770.
https://doi.org/10.1136/bmj.320.7237.768
XXXIX. Scott, S. D., Hirschinger, L. E., Cox, K. R., McCoig, M., Brandt, J., & Hall, L. W. (2009). The natural history of recovery for the healthcare provider “second victim” after adverse patient events. Quality and Safety in Health Care, 18(5), 325–330.
https://doi.org/10.1136/qshc.2009.032870
XL. Wu, A. W. (2000). Medical error: the second victim. BMJ, 320(7237), 726–727.
https://doi.org/10.1136/bmj.320.7237.726
XLI. de Vries, E. N., Prins, H. A., Crolla, R. M. P. H., den Outer, A. J., van Andel, G., van Helden, S. H., Schlack, W. S., van Putten, M. A., Gouma, D. J., Dijkgraaf, M. G. W., Smorenburg, S. M., & Boermeester, M. A. (2010). Effect of a Comprehensive Surgical Safety System on Patient Outcomes. New England Journal of Medicine, 363(20), 1928–1937.
https://doi.org/10.1056/NEJMsa0911535
XLII. Panagioti, M., Khan, K., Keers, R. N., Abuzour, A., Phipps, D., Kontopantelis, E., Bower, P., Campbell, S., Haneef, R., Avery, A. J., & Ashcroft, D. M. (2019). Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. BMJ, l4185. https://doi.org/10.1136/bmj.l4185
XLIII. Rosenstein, A. H., & O’Daniel, M. (2008). A Survey of the Impact of Disruptive Behaviors and Communication Defects on Patient Safety. The Joint Commission Journal on Quality and Patient Safety, 34(8), 464–471. https://doi.org/10.1016/S1553-7250(08)34058-6
XLIV. MANSER, T. (2009). Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiologica Scandinavica, 53(2), 143–151.
https://doi.org/10.1111/j.1399-6576.2008.01717.x
XLV. Singh, H., & Sittig, D. F. (2016). Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ Quality & Safety, 25(4), 226–232.
https://doi.org/10.1136/bmjqs-2015-004486
XLVI. Bates, D. W., & Gawande, A. A. (2003). Improving Safety with Information Technology. New England Journal of Medicine, 348(25), 2526–2534.
https://doi.org/10.1056/NEJMsa020847
XLVII. Leape, L. L., Shore, M. F., Dienstag, J. L., Mayer, R. J., Edgman-Levitan, S., Meyer, G. S., & Healy, G. B. (2012). Perspective. Academic Medicine, 87(7), 845–852.
https://doi.org/10.1097/ACM.0b013e318258338d
XLVIII. de Vries, E. N., Ramrattan, M. A., Smorenburg, S. M., Gouma, D. J., & Boermeester, M. A. (2008). The incidence and nature of in-hospital adverse events: a systematic review. Quality and Safety in Health Care, 17(3), 216–223.
https://doi.org/10.1136/qshc.2007.023622
XLIX. Rigó, M., Dragano, N., Wahrendorf, M., Siegrist, J., & Lunau, T. (2021). Work stress on rise? Comparative analysis of trends in work stressors using the European working conditions survey. International Archives of Occupational and Environmental Health, 94(3), 459–474. https://doi.org/10.1007/s00420-020-01593-8
L. Iacovides, A., Fountoulakis, K. N., Kaprinis, S., & Kaprinis, G. (2003). The relationship between job stress, burnout and clinical depression. Journal of Affective Disorders, 75(3), 209–221.
https://doi.org/10.1016/S0165-0327(02)00101-5
LI. Shanafelt, T. D., West, C. P., Sinsky, C., Trockel, M., Tutty, M., Satele, D. V., Carlasare, L. E., & Dyrbye, L. N. (2019). Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017. Mayo Clinic Proceedings, 94(9), 1681–1694.
https://doi.org/10.1016/j.mayocp.2018.10.023
LII. Kluger, M. T., Townend, K., & Laidlaw, T. (2003). Job satisfaction, stress and burnout in Australian specialist anaesthetists. Anaesthesia,58(4),339–345.
https://doi.org/10.1046/j.1365-2044.2003.03085.x
LIII. Faragher, E. B., Cass, M., & Cooper, C. L. (2005). The relationship between job satisfaction and health: a meta-analysis. Occupational and Environmental Medicine, 62(2), 105–112.
https://doi.org/10.1136/oem.2002.006734
LIV. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job Burnout. Annual Review of Psychology, 52(1), 397–422.
https://doi.org/10.1146/annurev.psych.52.1.397
LV. Shanafelt, T., Goh, J., & Sinsky, C. (2017). The Business Case for Investing in Physician Well-being. JAMA Internal Medicine, 177(12), 1826. https://doi.org/10.1001/jamainternmed.2017.4340
LVI. Wallace, J. E., Lemaire, J. B., & Ghali, W. A. (2009). Physician wellness: a missing quality indicator. The Lancet, 374(9702), 1714–1721. https://doi.org/10.1016/S0140-6736(09)61424-0
LVII. Thomas, L. R., Ripp, J. A., & West, C. P. (2018). Charter on Physician Well-being. JAMA, 319(15), 1541. https://doi.org/10.1001/jama.2018.1331
LVIII. Weaver, S. J., Lubomksi, L. H., Wilson, R. F., Pfoh, E. R., Martinez, K. A., & Dy, S. M. (2013). Promoting a Culture of Safety as a Patient Safety Strategy. Annals of Internal Medicine, 158(5_Part_2), 369–374.
https://doi.org/10.7326/0003-4819-158-5-201303051-00002
LIX. Leape, L., Berwick, D., Clancy, C., Conway, J., Gluck, P., Guest, J., Lawrence, D., Morath, J., O’Leary, D., O’Neill, P., Pinakiewicz, D., & Isaac, T. (2009). Transforming healthcare: a safety imperative. Quality and Safety in Health Care, 18(6), 424–428.
https://doi.org/10.1136/qshc.2009.036954
LX. MANSER, T. (2009). Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiologica Scandinavica, 53(2), 143–151.
https://doi.org/10.1111/j.1399-6576.2008.01717.x
LXI. Oesterle, T. S., Thusius, N. J., Rummans, T. A., & Gold, M. S. (2019). Medication-Assisted Treatment for Opioid-Use Disorder. Mayo Clinic Proceedings, 94(10), 2072–2086.
https://doi.org/10.1016/j.mayocp.2019.03.029
LXII. Shanafelt, T. D., Dyrbye, L. N., Sinsky, C., Hasan, O., Satele, D., Sloan, J., & West, C. P. (2016). Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction. Mayo Clinic Proceedings, 91(7), 836–848. https://doi.org/10.1016/j.mayocp.2016.05.007
LXIII. Melnick, E. R., Dyrbye, L. N., Sinsky, C. A., Trockel, M., West, C. P., Nedelec, L., Tutty, M. A., & Shanafelt, T. (2020). The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians. Mayo Clinic Proceedings, 95(3), 476–487.
https://doi.org/10.1016/j.mayocp.2019.09.024
LXIV. Gardner, R. L., Cooper, E., Haskell, J., Harris, D. A., Poplau, S., Kroth, P. J., & Linzer, M. (2019). Physician stress and burnout: the impact of health information technology. Journal of the American Medical Informatics Association, 26(2), 106–114. https://doi.org/10.1093/jamia/ocy145
LXV. Arndt, B. G., Beasley, J. W., Watkinson, M. D., Temte, J. L., Tuan, W.-J., Sinsky, C. A., & Gilchrist, V. J. (2017). Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations. The Annals of Family Medicine, 15(5), 419–426. https://doi.org/10.1370/afm.2121
LXVI. Greenhalgh, T., Wherton, J., Shaw, S., & Morrison, C. (2020). Video consultations for covid-19. BMJ, m998. https://doi.org/10.1136/bmj.m998
LXVII. Car, J., Koh, G. C.-H., Foong, P. S., & Wang, C. J. (2020). Video consultations in primary and specialist care during the covid-19 pandemic and beyond. BMJ, m3945.