Evidence mapPaperPMID 40375323Full record

ArticleBMC health services research2025

Association of emergency department nurse and physician work environment agreement on clinician job and patient outcomes.

K Jane Muir, Anish K Agarwal, Daniela Golinelli, Karen B Lasater, James Ballinghoff, Colleen Mattioni, Matthew D McHugh, Linda H Aiken, United States Clinician Wellbeing Study Consortium

Abstract read
In one paragraph

Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

K Jane MuirCenter for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Fagin Hall, Philadelphia, PA, 19104, USA. janemuir@nursing.upenn.edu.
Anish K AgarwalThe Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Daniela GolinelliCenter for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Fagin Hall, Philadelphia, PA, 19104, USA.
Karen B LasaterCenter for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Fagin Hall, Philadelphia, PA, 19104, USA.
James BallinghoffPenn Presbyterian Medical Center and UPHS, Philadelphia, PA, USA.
Colleen MattioniHospital of the University of Pennsylvania, Philadelphia, PA, USA.
Matthew D McHughCenter for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Fagin Hall, Philadelphia, PA, 19104, USA.
Linda H AikenCenter for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Fagin Hall, Philadelphia, PA, 19104, USA.
United States Clinician Wellbeing Study Consortium

Funding

ADVANCED TRAINING IN NURSING OUTCOMES RESEARCHT32NR007104 · UNIVERSITY OF PENNSYLVANIA · 1999 to 2025
$2.6M
Multilevel Panel Study of Effects of Changes in Nursing on Patient OutcomesR01NR014855 · NINR · UNIVERSITY OF PENNSYLVANIA · 2024 to 2025
$1.5M
AHRQ HHS AHRQ R01HS028978NIH HHS R01 NR014855NIH HHS T32 NR007104
6 · The paper itself

Abstract

backgroundEmergency medicine is a highly interdisciplinary field, and emergency nurses and physicians have high rates of burnout compared to other specialties. National and international agencies prioritize investments in systems-based solutions to improve clinicians' work environments. The objective of this study was to determine whether emergency department (ED) clinicians agree on the quality of work environments, and whether their agreement is associated with job outcomes, patient safety, and quality of care.

methodsThis cross-sectional study used data from 1,604 ED nurses (n = 1,190) and physicians (n = 414) who completed the 2021 US Clinician Wellbeing Study in 47 Magnet hospitals. A K-means algorithm classified hospitals into 'profiles' based on nurse and physician agreement on work environment assessments. Hospital-level linear regression models determined the relationship between hospital profiles and clinician job and patient outcomes.

resultsThe overall clinician sample (n = 1,604) was on average 39.4 years of age (SD = 11.2), 72.3% female, with 8.3 years of experience (SD = 7.9), 77.7% White, and 93.6% non-Hispanic. Two hospital profiles indicated clinician agreement: "Agree, Unfavorable Environment" (n = 10 hospitals), and "Agree, Favorable Environment" (n = 15); the third profile indicated disagreement: "Disagree, Less Favorable Environment among Nurses" (n = 22). There were no hospital profiles with physicians rating their work environment less favorably than nurses. Compared to the "Agree, Favorable Environment" hospitals, the "Agree, Unfavorable Environment" and "Disagree, Less Favorable among Nurses" hospitals were associated with higher burnout (e.g., β = 25.8%, 95% CI 11.6, 40.1, p <.001 and β = 15.4, 95% CI 3.7, 27.2, p <.001, respectively), job dissatisfaction, and intent to leave; and unfavorable patient care quality and unfavorable patient safety grades (e.g., β = 29.1%, 95% CI 18.4, 39.8, p <.001 and β = 11.9%, 95% CI 3.0, 20.8, p <.01, respectively).

conclusionsIn this cross-sectional study, emergency nurses and physicians in almost half of study hospitals disagreed on the quality of the work environment, suggesting that two essential collaborators in high-stakes care do not agree on deficiencies in ED work environments. Sustainable systems-based solutions to improve ED work environments involve bridging these disparate workplace experiences.

Indexed as

Emergency Service, HospitalNursing Staff, HospitalPhysiciansWorkplaceAdultBurnout, ProfessionalCross-Sectional StudiesFemaleHumansJob SatisfactionMaleMiddle AgedPatient SafetyQuality of Health CareUnited StatesWorking ConditionsBurnoutEmergency careWell-beingWork environment

Identifiers

PMID40375323
PMCPMC12083161

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.