title: Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review.
abstract: OBJECTIVE
  To determine whether there is an association between healthcare professionals' wellbeing and burnout, with patient safety.
  
  
  METHODS
  Systematic research review.
  
  
  METHODS
  PsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles.
  
  
  METHODS
  Quantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations.
  
  
  RESULTS
  Forty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety.
  
  
  CONCLUSIONS
  Poor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed.
  
  
  CONCLUSIONS
  This review illustrates the need for healthcare organisations to consider improving employees' mental health as well as creating safer work environments when planning interventions to improve patient safety.
  
  
  BACKGROUND
  PROSPERO registration number: CRD42015023340.
authors.affiliation: School of Psychology, University of Leeds, Leeds, West Yorkshire, England.|Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, West Yorkshire, England.
authors.forename: Louise H
authors.initials: LH
authors.lastname: Hall
authors.affiliation: School of Psychology, University of Leeds, Leeds, West Yorkshire, England.|Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford, West Yorkshire, England.
authors.forename: Judith
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Department of Health Sciences, University of York, York, North Yorkshire, England.
authors.forename: Ian
authors.initials: I
authors.lastname: Watt
authors.affiliation: School of Psychology, University of Leeds, Leeds, West Yorkshire, England.|Leeds City Council, Leeds, West Yorkshire, England.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Tsipa
authors.affiliation: School of Psychology, University of Leeds, Leeds, West Yorkshire, England.
authors.forename: Daryl B
authors.initials: DB
authors.lastname: O'Connor
mesh_terms: D002055:Burnout, Professional / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D006282:Health Personnel / Q000458:organization & administration / Q000523:psychology*; D006801:Humans; D008297:Male; D008603:Mental Health; D061214:Patient Safety; D006113:United Kingdom