Rates of medication errors among depressed and burnt out residents: prospective cohort study

doi:10.1136/bmj.39469.763218.BE

BMJ 2008;336:488-491 (1 March), doi:10.1136/bmj.39469.763218.BE (published 7 February 2008)

Research

Rates of medication errors among depressed and burnt out residents: prospective cohort study

Amy M Fahrenkopf, instructor of paediatrics¹, Theodore C Sectish, associate professor of paediatrics², Laura K Barger, research fellow³, Paul J Sharek, assistant professor of paediatrics², Daniel Lewin, assistant professor of psychiatry and paediatrics⁴, Vincent W Chiang, assistant professor of paediatrics¹, Sarah Edwards, project coordinator³, Bernhard L Wiedermann, associate professor of paediatrics⁴, Christopher P Landrigan, assistant professor of paediatrics and medicine¹^,3

¹ Harvard Medical School, Department of Medicine, Children’s Hospital Boston, Boston, MA 02115, USA, ² Stanford Medical School, Lucile Packard Children’s Hospital, Palo Alto, CA, USA, ³ Division of Sleep Medicine, Brigham and Women’s Hospital, Boston, MA, USA, ⁴ George Washington University Medical School, Children’s National Medical Center, Washington, DC, USA

Correspondence to: A M Fahrenkopf amy.fahrenkopf{at}tch.harvard.edu

Objective To determine the prevalence of depression and burnoutamong residents in paediatrics and to establish if a relationexists between these disorders and medication errors.

Design Prospective cohort study.

Setting Three urban freestanding children’s hospitalsin the United States.

Participants 123 residents in three paediatric residency programmes.

Main outcome measures Prevalence of depression using the Harvardnational depression screening day scale, burnout using the Maslachburnout inventory, and rate of medication errors per residentmonth.

Results 24 (20%) of the participating residents met the criteriafor depression and 92 (74%) met the criteria for burnout. Activesurveillance yielded 45 errors made by participants. Depressedresidents made 6.2 times as many medication errors per residentmonth as residents who were not depressed: 1.55 (95% confidenceinterval 0.57 to 4.22) compared with 0.25 (0.14 to 0.46, P<0.001).Burnt out residents and non-burnt out residents made similarrates of errors per resident month: 0.45 (0.20 to 0.98) comparedwith 0.53 (0.21 to 1.33, P=0.2).

Conclusions Depression and burnout are major problems amongresidents in paediatrics. Depressed residents made significantlymore medical errors than their non-depressed peers; however,burnout did not seem to correlate with an increased rate ofmedical errors.

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Rapid Responses:

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