Patients are at risk because of poor hospital work environments, which need to be improved. So says a new Health Affairs study.

We’ll let that sink in.

Hospital work environments are a danger to patients. Researchers said they analyzed nurse and patient appraisals at 535 hospitals in four states between 2005 and 2016 — a fairly exhaustive study — to determine whether the work environment had improved and the extent to which those changes affected patient safety.

Of those studies, 21 percent of the hospitals showed significant improvements (better than 10 percent) in work environment scores, while 7 percent did worse. "Where clinical care environments improved, nurses and patients cited positive strides on patient safety indicators," the authors of the report said.

In a 2017 survey, Healthcare Dive reported recently, about half of all nurses said they were thinking about leaving the field because of feelings of being overworked, workplace harassment or inadequate pay. About two-thirds blamed their heavy workload on the ongoing nursing shortage.

According to the American Medical Association and Medscape, physicians from 27 specialties graded the severity of their burnout on a scale of one to seven — one being that it does not interfere, and seven indicating thoughts of leaving medicine.

In that Medscape survey, all but one specialty selected a four or higher. The most affected specialty was emergency medicine, with nearly 60 percent of ED physicians saying they feel burned out.

"Too many bureaucratic tasks, spending too many hours at work, feeling like just a cog in a wheel, increased computerization of practice," said the Medscape Lifestyle Report 2017.

Back to the original study: Hospitals that worked to improve workplace environments performed better on a number of patient safety indicators. The number of patients rating their hospital favorably increased by 11 percent and those who would recommend the hospital grew 8 percent. Positive nurse appraisals on quality of care and patient safety each rose 15 percent.

According to the study, a third of nurses rated their work environment as fair or poor from 2015 to 2016. “Burnout was particularly high, with nearly a third of bedside nurses registering high on the Maslach Burnout Inventory,” the study found.

Hospitals where work environments decline experienced a 19 percent drop in nurses giving favorable grades on patient safety. Ramifications can be far-reaching: Clinical safety interventions like surgical checklists and rapid-response teams can be “undermined because of issues like staff shortages or missing equipment or supplies.”

According to the study, nurses are forced to drop what they're doing on average once an hour to deal with operational shortcomings.

"Our findings confirm that nurses spend substantial time troubleshooting recurring operational problems, interrupting care and creating patient safety hazards," the authors write. "RNs are an expensive and scarce resource to use in this manner, when their greatest value is in direct patient care … [M]ore attention is needed to redesign work flows to permanently solve persistent operational failures that take nurses away from direct patient care."