Implications of Occupational Stress and Burnout on Patient Safety at Public Hospitals in Malawi

Due to an acute shortage of medical doctors, clinical officers (COs) in Malawi are tasked with duties that conventionally fall within the purview of the former. The purpose of this paper is to demonstrate that excessive workload and long hours of work are psychosocial hazards that contribute to occupational stress (OS) and burnout among COs at public hospitals. The study used a qualitative research approach. The study sites comprised five state-owned hospitals: Mulanje District Hospital, Chikwawa District Hospital, Balaka District Hospital, Nkhata Bay District Hospital, and Queen Elizabeth Central Hospital in Blantyre. Three methods of data collection were used: semistructured interviews, focus group discussions, and document analysis. Thematic analysis was employed as a method of data analysis. The study found that the cognitive effects of OS and burnout among COs are eventually externalized to the general public through medical errors and mistakes. The study concluded that the medical errors and mistakes associated with the cognitive effects of OS and burnout among COs pose negative impacts on patient safety. The medical errors and mistakes associated with OS and burnout are ultimately impediments to patient satisfaction. Hence, this paper coins the term ‘impact shifting’ to refer to the externalization of the consequences of OS and burnout among COs to the general public through poor patient safety and ultimately low patient satisfaction.