Lindsay J Blazin1,2, Michael A Terao1,3, Holly Spraker-Perlman4, Justin N Baker4, Valerie McLaughlin Crabtree5, Belinda N Mandrell6, Jami Gattuso6, Janet Sellers7, Tyler J Dunn8,9, Zhaohua Lu10, James M Hoffman8,11, Jonathan D Burlison11. 1. Department of Oncology, St Jude Children's Research Hospital, Memphis, TN. 2. Department of Pediatrics, Division of Pediatric Hematology Oncology, Indiana University, Indianapolis, IN. 3. Department of Pediatrics, Division of Pediatric Adolescent and Young Adult Hematology and Oncology, Medstar Georgetown University Hospital, Washington, DC. 4. Department of Oncology, Division of Quality of Life and Palliative Care, St Jude Children's Research Hospital, Memphis, TN. 5. Department of Psychology, St Jude Children's Research Hospital, Memphis, TN. 6. Department of Pediatric Medicine, Division of Nursing Research, St Jude Children's Research Hospital, Memphis, TN. 7. Department of Psychosocial Services, St Jude Children's Research Hospital, Memphis, TN. 8. Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, TN. 9. Department of Pharmacy Administration, University of Mississippi, Oxford, MS. 10. Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN. 11. Office of Quality and Patient Care, St Jude Children's Research Hospital, Memphis, TN.
Abstract
PURPOSE: Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment because of chronic occupational stress. Approximately one third of pediatric hematology-oncology physicians experience burnout. The goal of this mixed methods study was to determine the prevalence and drivers of burnout among physicians caring for pediatric hematology-oncology patients at our institution. MATERIALS AND METHODS: This mixed methods, cross-sectional study was conducted at a large academic cancer center. Validated survey instruments were used to measure burnout, job demands, experience with patient safety events, and workplace culture. Quantitative data informed development of a semistructured interview guide, and physicians were randomly selected to participate in individual interviews. Interviews were transcribed and analyzed via content analysis based on a priori codes. RESULTS: The survey was distributed to 132 physicians, and 53 complete responses were received (response rate 40%). Of the 53 respondents, 15 (28%) met criteria for burnout. Experiencing burnout was associated with increased temporal demand. Twenty-six interviews were conducted. Qualitative themes revealed that frequent meetings, insufficient support staff, and workflow interruptions were key drivers of temporal demand and that temporal demand contributed to burnout through emotional exhaustion and reduced personal accomplishment. CONCLUSION: Nearly one-third of participating physicians met criteria for burnout, and burnout was associated with increased temporal demand. Qualitative interviews identified specific drivers of temporal demand and burnout, which can be targeted for intervention. This methodology can be easily adapted for broad use and may represent an effective strategy for identifying and mitigating institution-specific drivers of burnout.
PURPOSE: Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment because of chronic occupational stress. Approximately one third of pediatric hematology-oncology physicians experience burnout. The goal of this mixed methods study was to determine the prevalence and drivers of burnout among physicians caring for pediatric hematology-oncology patients at our institution. MATERIALS AND METHODS: This mixed methods, cross-sectional study was conducted at a large academic cancer center. Validated survey instruments were used to measure burnout, job demands, experience with patient safety events, and workplace culture. Quantitative data informed development of a semistructured interview guide, and physicians were randomly selected to participate in individual interviews. Interviews were transcribed and analyzed via content analysis based on a priori codes. RESULTS: The survey was distributed to 132 physicians, and 53 complete responses were received (response rate 40%). Of the 53 respondents, 15 (28%) met criteria for burnout. Experiencing burnout was associated with increased temporal demand. Twenty-six interviews were conducted. Qualitative themes revealed that frequent meetings, insufficient support staff, and workflow interruptions were key drivers of temporal demand and that temporal demand contributed to burnout through emotional exhaustion and reduced personal accomplishment. CONCLUSION: Nearly one-third of participating physicians met criteria for burnout, and burnout was associated with increased temporal demand. Qualitative interviews identified specific drivers of temporal demand and burnout, which can be targeted for intervention. This methodology can be easily adapted for broad use and may represent an effective strategy for identifying and mitigating institution-specific drivers of burnout.
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