Beyond Burnout

A privilege of serving as ACCC President is selecting a theme for your term in office and then having the opportunity to bring together thought leaders and key stakeholders for an in-depth conversation to explore the issue and develop strategies to address it. On June 27, 2018, the sixth annual ACCC Institute for the Future of Oncology forum was held in Washington, D.C., for a conversation focused on my ACCC President’s theme “Reflect, Renew, Reignite: Creating a Resilient Oncology Team in Your Community.” During the half-day meeting, experts and leaders from within and outside of oncology participated in activities to spark creative thinking and dialogue, breaking into small groups to discuss two critical areas with great potential to impact resiliency and well-being: 1) organizational structure and culture and 2) practice efficiency and administrative burden.

While it’s difficult to convey the dynamic energy of the day’s discussion here, I can share some key takeaways:

• Leaders must see well-being as a strategic initiative and fund it accordingly; they must prioritize a healthy workforce by investing in the necessary staff and infrastructure to meet this goal. Many organizations have created the executive level position of Chief Experience Officer to oversee the efforts for employee engagement and well-being as well as patient satisfaction. To be successful, organizations and individuals must make well-being a priority.
• Although physician resiliency and burnout have garnered attention, there is a critical need to develop tools and resources for the entire cancer care team. The Cleveland Clinic has taken the step of defining every staff member who has contact with a patient as a caregiver. Each one of these team members can experience burnout.
• Resilient, engaged cancer care teams provide better service and produce better outcomes for our patients.
• Throughout the cancer care system, varying levels of burnout frequently exist. This is often manifested as physical fatigue, compassion fatigue, and emotional depletion.
• Practices must normalize wellness and self-care by setting them as expectations and creating an environment where people feel safe to show vulnerability.
• Trusting leadership and believing in organizational values are essential to a healthy workforce. It is critical to create a culture of trust where staff knows there will be follow-up for concerns and issues.
• When designing wellness interventions, cancer programs and practices should include team members from all levels of the organization rather than developing a top-down strategy and imposing it on staff.
• There must be acknowledgement that there are some drivers of burnout that individuals and organizations cannot change; thus, there should be a focus on those areas where individuals and organizations can have an impact.

The Institute meeting is just the initial step in the Association’s year-long effort to develop tools and resources to support wellness and resiliency for every member of the multidisciplinary cancer team. Over the next few months, we will:

• Construct a burnout measure specifically for cancer care team members, adapted from an existing validated tool
• Develop a web-based repository of oncology-specific tools related to burnout, resiliency, and well-being
• Create a resource for building and articulating the business case for improving the well-being of the cancer care team.

To enrich our offerings, we are asking ACCC members to share their experiences working toward improving the resiliency and well-being of cancer program staff. What sort of programs have you tried? Were these focused on the individual, program, or hospital- or health-system level? What worked? What were your challenges? How did you measure improvement? Please send a short description of your efforts—including any tools or resources you’d like to share with others—to mmarino@accc-cancer.org. And keep in touch. Improving the well-being of the cancer care team is important work that we must do together. Our colleagues and our patients deserve nothing less.

Tom Gallo, MS, MDA, ACCC President 2018-2019, is Executive Director of the Virginia Cancer Institute.