By Dr. Linda Burns, National Marrow Donor Program/Be The Match
Our profession has long been committed to enhancing the quality of care for patients in need of a potentially life-saving hematopoietic cell transplant (HCT). Increasingly, there is a recognition that the quality of care depends on a healthy work force. Burnout, a syndrome of depersonalization (feeling of cynicism), emotional exhaustion, and low personal accomplishment adversely affects the well-being of providers and the quality of care provided. As HCT providers frequently care for very ill patients, moral distress that occurs when a provider is unable to provide the care perceived to be best for a patient may also adversely affect clinicians’ well-being.
A lack of understanding of the prevalence and drivers of burnout and moral distress prompted myself, Joyce Neumann and colleagues to lead the first national survey of the multidisciplinary HCT team (advanced practice providers, physicians, nurses, pharmacists and social workers). We found the prevalence of burnout differed by discipline, but overall was 40 percent. Providers with burnout were more likely to report inadequate work-life balance and a low level of career satisfaction. Indeed, 81 percent of those who were not satisfied with their career in HCT felt burned out. The prevalence of moral distress also varied by discipline, but importantly was a significant contributing factor to burnout for all. The manuscript detailing results of this study was published in Biology of Blood and Marrow Transplantation. I will present the results and potential strategies to promote clinician well-being at the upcoming 2018 Clinical Education Conference in Nashville, Tenn.
The American Society for Blood and Marrow Transplantation (ASBMT), National Marrow Donor Program (NMDP)/Be The Match, and Canadian Blood and Marrow Transplantation Group are committed to using these findings to develop interventions that mitigate the adverse effects of burnout and moral distress, with the recognition that there is likely no single solution across disciplines. In 2017, we were among the first, of now over 150 organizations, to commit to the National Academy of Medicine’s Action Collaborative on Clinician Well-Being and Resilience. The full statement can be viewed here.
In addition to the adverse impacts of burnout and moral distress on the quality of patient care, they are also potential barriers to the recruitment and retention of the transplant work force. In focus groups conducted prior to the launch of the national survey, poor work-life balance was an oft-repeated concern and a primary reason voiced by physician trainees for not entering the transplant field. Likewise, in a pilot survey of active physicians, it was a primary reason for those planning to leave the field.
The time for action is now, so we hope you’ll bring your ideas and join the discussion at the Clinical Education Conference in Nashville.
Hear Dr. Linda Burns talk more about clinician well-being at the Clinical Education Conference in her breakout sessions. See a full agenda of events here.