To gauge the level of burnout in the multidisciplinary cancer care team, ACCC recently surveyed its membership using the clinically validated Mini Z survey developed by the American Medical Association. While only a small number of respondents (14.9%) report dissatisfaction with their current job, burnout and stress levels are significant.
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ACCC President-Elect Krista Nelson shares how Providence Cancer Institute has made staff resiliency and morale a priority during the COVID-19 pandemic.
The sixth annual ACCC Institute held in Washington, D.C., on June 27, 2018, convened more than 30 experts in cancer care, wellness, and resiliency to share insights on what is fueling burnout among members of the cancer care team and what needs to happen on both on both a micro and macro level to support and improve team well-being. The day-long forum discussion focused on ACCC President Tom Gallo’s 2018-2019 presidential theme: Reflect, Renew, Reignite: Creating a Resilient Oncology Team in Your Community.
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After a review of key performance indicators, including charge lag, month-end close, patient registration, and insurance identification and verification, this cancer program leveraged its EHR and billing data to identify actionable areas for improvement. Four primary impacts of silo mentality were identified: resource waste, incorrect denials, reduced cash flow, and increased risk for financial toxicity. Performance improvements were prioritized using a matrix to grade urgency and importance.
Re-structuring care delivery to be more patient centered is among the many demands the U.S. healthcare system is striving to meet. The imperative to center care around engaged patients is recognized by regulators, health systems, hospitals, professional societies, providers, payers, and patients and families—and it is a central component of value-based care.
Of the Institute for Healthcare Improvement Triple Aim domains to achieve optimal health system performance, the first is: Improve the patient experience of care (including quality and satisfaction).
At last week’s 35th ACCC National Oncology Conference in Phoenix, featured speaker Julie Oehlert, DNP, RN, took issue with patient “satisfaction” as a metric for the patient experience. Healthcare “has gone down the customer satisfaction route as a measure of quality,” she said, “. . . can patients [ever] be ‘satisfied’ with a diagnosis of cancer?” Even though many healthcare organizations have moved from “patient satisfaction” to the concept of patient experience, “We didn’t move our strategies or tactics to measure this. We used the same old customer service tools.”
To move the needle on patient experience, she believes we must start by recognizing that “healthcare is a relationship between those who provide care and those who seek care.”
Recalling an article by Thomas Bodenheimer, MD, and Christine Sinsky, MD, (Annals of Family Medicine, 2014) that makes the case for moving from the Triple Aim to the Quadruple Aim, with the addition of “improving the work life of health care clinicians and staff,” Oehlert concurs. “You won’t hit the IHI Triple Aim unless you add the Quadruple Aim of improving health and well-being of staff.”
Today, the issues of burnout and the well-being of clinicians and healthcare team members are a national concern. In 2017 the National Academy of Medicine established its Action Collaborative on Clinician Well-Being and Resilience. The Collaborative's website outlines multiple factors contributing to the problems of burnout and stress, acknowledging that “Organizational leadership, culture, and policies can play a significant role in burnout and well-being.”
Yet in a pop-up poll during Dr. Oehlert’s presentation, 93% of conference attendees said that their cancer program or practice did not measure staff or clinician burnout.
This scenario is something Dr. Oehlert hopes to see turn around. At Vidant Health, the “journey to promote a caring and compassionate culture,” is already underway. At the health system, she is responsible not only for the patients’ experience but also for the team members’ experience. The focus is on the “BIG E—Everyone’s Experience Matters,” she said. “How we [the healthcare team] experience each other begets the patient experience.”
ACCC President Tom Gallo’s presidential theme is “Reflect, Renew, Reignite: Building a Resilient Oncology Team in Your Community.” How is your cancer program addressing team well-being and fostering resilience? If your cancer program has a wellness initiative underway, contact us. Be sure to visit the NAM Action Collaborative Knowledge Hub for resources and tools.
Burnout is on the rise as oncology becomes increasingly complex with new treatment options, growing financial toxicity, an aging patient population, and an increasingly burdensome healthcare system. It has received much media attention, with some calling it an epidemic.
Thomas A. Gallo, MS, MDA, ACCC President, selected his 2018–2019 president’s theme: Reflect, Renew, Reignite: Creating a Resilient Oncology Team in Your Community, in order to shed light on the pain points that frustrate physicians, nurses, social workers, administrators, pharmacists, and all of the other professionals who collaborate to provide the highest level of patient care.
The ACCC 35th National Oncology Conference, October 17 – 19, in Phoenix, AZ, featured stories and strategies for fostering resilience and a healthcare culture that mitigates burnout among all members of the cancer care team. Three featured speakers inspired while providing practical strategies to help increase engagement, transform your work culture, and embrace experimentation.
ACCC is committed to identifying shared strategies and solutions to help combat the burnout and frustration that many of its members experience. This Building a Resilient Oncology Team: Issues and Solutions infographic details key findings on clinician burnout and a bevy of solutions to help you mitigate stress and bring the joy back to your workplace.
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