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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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.
Although nearly three-fourths of respondents to a 2019 ACCC survey of its membership reported "overall satisfaction" with their current position, nearly 59 percent said they either "agree" or "strongly agree" with the statement: “I feel a great deal of stress because of my job.” Fifty-six percent ranked the atmosphere in their primary work area as a “4” or “5” on a scale of 1 to 5, in which 1 is “calm” and 5 is “hectic, chaotic.” Perhaps most concerning, 41 percent described their workplace as “unreasonably busy,” and 33 percent said they are “definitely burning out.”
With these responses in mind, Linda D. Bosserman, MD, Assistant Clinical Professor at City of Hope in Duarte, California, and Kathleen LaRaia, MS, Executive Director of Oncology Services at Munson Healthcare in Traverse City, Michigan, offered some strategies to oncology leaders for addressing workplace burnout. During a workshop at the recent ACCC 45th Annual Meeting & Cancer Center Business Summit, Dr. Bosserman and Ms. LaRaia described some of the reasons behind the rise in burnout among members of the cancer care team and shared a some tactics to help restore workplace resilience.
Staff burnout can take a significant toll on patient care and clinician well-being. In her March 22 presentation, Dr. Bosserman described a recent American Medical Association report that found that with each percentage point increase in physician burnout, the likelihood that physicians will report a medical error increases 3 percent to 10 percent. On a personal level, physician burnout correlates with higher rates of work dissatisfaction, divorce, depression, alcohol and drug abuse, and even suicide.
Dr. Bosserman and LaRaia say the main drivers of burnout in today’s cancer care environment stem from five key causes:
To address the trends in healthcare delivery that are dragging down employee morale, Dr. Bosserman said City of Hope gave its staff members surveys that asked them to identify their specific stressors and suggest ways to ameliorate them. In a 2018 survey, 73 percent of 92 respondents reported symptoms of burnout. Respondents said that significantly contributing to their burnout was the amount of time they spent documenting their work in their EHR. Seventy-four percent said their proficiency in using their EHR was marginal to poor, and 47 percent said they spend moderately high to excessive amounts of time entering data into their EHR while they are at home. Accordingly, the top two strategies survey respondents identified to reduce their stress levels were improving workplace efficiencies within their teams and reducing the clerical burden of EHRs.
City of Hope responded to these staff concerns by addressing inefficient workflows and processes and providing additional EHR training. Although these remedies adopted a multi-pronged approach to decrease and streamline workloads, City of Hope found that even small changes could make a big difference. A faster, seven-second log-in to the EHR system saved an estimated 9,100 provider hours per year. A transition to team-based care and a medical scribe pilot program are currently underway at City of Hope to further address the inefficiencies staff members identified in the survey.
After presenting, Dr. Bosserman and LaRaia invited workshop participants to identify what their organizations should stop doing, start doing, do less of, and do more of to address workplace stress and burnout. Among the responses were:
If your cancer program or practice has an innovative program that addresses wellness and resiliency in the workplace, we want to hear from you. Email email@example.com to share your story.
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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