Emergency Physician Stress and Its Impact on Patient Outcomes: Development and Validation of a Multidimensional Assessment Tool

<i>Background:</i> Emergency physicians (EPs) work in unpredictable, high-pressure environments that demand rapid clinical decisions and constant multitasking. Such conditions expose them to significant occupational stress, which, if persistent or unmanaged, can impair judgment, reduce job satisfaction, and increase the likelihood of burnout. Understanding and accurately measuring this stress is essential to improving physician well-being and patient safety. <i>Objective:</i> This study aimed to develop and validate a multidimensional tool to assess stress among emergency physicians and to explore its relationship with key patient-related outcomes. <i>Methods:</i> A cross-sectional study was conducted in Sudan from February to July 2025. A structured, self-administered online questionnaire was distributed to practicing emergency physicians across multiple hospitals. The tool underwent content and construct validation, with exploratory factor analysis used to identify underlying stress domains. Logistic regression was applied to examine associations between overall stress levels and self-reported clinical outcomes, including medical errors and turnover intention. <i>Results:</i> A total of 202 emergency physicians completed the survey. Four primary stress domains were identified: burnout, workload, psychological distress, and system-related stress. Higher composite stress scores were significantly correlated with increased reports of medical errors (p < 0.01) and a greater intention to leave their current position (p < 0.05). <i>Conclusion:</i> The developed instrument demonstrated strong validity and reliability in assessing multiple aspects of emergency physician stress. Findings highlight that elevated stress levels adversely affect both clinicians and patients. Implementing structured support systems, promoting coping strategies, and enhancing workplace resilience are essential to reduce stress and improve emergency care quality.