scholarly journals Occupational and Personal Consequences of the COVID-19 Pandemic on US Oncologist Burnout and Well-Being: A Study From the ASCO Clinician Well-Being Task Force

2021 ◽  
pp. OP.21.00147
Author(s):  
Fay J. Hlubocky ◽  
Anthony L. Back ◽  
Tait D. Shanafelt ◽  
Colleen M. Gallagher ◽  
John M. Burke ◽  
...  
Keyword(s):  
Personal Growth ◽  
Cancer Care ◽  
Task Force ◽  
Care Delivery ◽  
Qualitative Interviews ◽  
Well Being ◽  
Professional Organizations ◽  
Framework Analysis ◽  
Virtual Focus Groups ◽  
Personal Consequences

INTRODUCTION: The COVID-19 pandemic is an unprecedented global crisis profoundly affecting oncology care delivery. PURPOSE: This study will describe the occupational and personal consequences of the COVID-19 pandemic on oncologist well-being and patient care. MATERIALS AND METHODS: Four virtual focus groups were conducted with US ASCO member oncologists (September-November 2020). Inquiry and subsequent discussions centered on self-reported accounts of professional and personal COVID-19 experiences affecting well-being, and oncologist recommendations for well-being interventions that the cancer organization and professional societies (ASCO) might implement were explored. Qualitative interviews were analyzed using Framework Analysis. RESULTS: Twenty-five oncologists were interviewed: median age 44 years (range: 35-69 years), 52% female, 52% racial or ethnic minority, 76% medical oncologists, 64% married, and an average of 51.5 patients seen per week (range: 20-120). Five thematic consequences emerged: (1) impact of pre-COVID-19 burnout, (2) occupational or professional limitations and adaptations, (3) personal implications, (4) concern for the future of cancer care and the workforce, and (5) recommendations for physician well-being interventions. Underlying oncologist burnout exacerbated stressors associated with disruptions in care, education, research, financial practice health, and telemedicine. Many feared delays in cancer screening, diagnosis, and treatment. Oncologists noted personal and familial stressors related to COVID-19 exposure fears and loss of social support. Many participants strongly considered working part-time or taking early retirement. Yet, opportunities arose to facilitate personal growth and rise above pandemic adversity, fostering greater resilience. Recommendations for organizational well-being interventions included psychologic or peer support resources, flexible time-off, and ASCO and state oncology societies involvement to develop care guidelines, well-being resources, and mental health advocacy. CONCLUSION: Our study suggests that the COVID-19 pandemic has adversely affected oncologist burnout, fulfillment, practice health, cancer care, and workforce. It illuminates where professional organizations could play a significant role in oncologist well-being.

scholarly journals Evolution of Cancer Care Delivery Research in the NCI Community Oncology Research Program

2019 ◽  
Vol 112 (6) ◽  
pp. 557-561 ◽  
Author(s):  
Ann M Geiger ◽  
Ann M O’Mara ◽  
Worta J McCaskill-Stevens ◽  
Brenda Adjei ◽  
Priyanga Tuovenin ◽  
...  
Keyword(s):  
Research Program ◽  
National Cancer Institute ◽  
Cancer Care ◽  
Care Delivery ◽  
Well Being ◽  
Practice Change ◽  
Evidence Based ◽  
Oncology Research ◽  
Community Oncology ◽  
Robust Portfolio

Abstract Research seeking to improve patient engagement with decision-making, use of evidence-based guidelines, and coordination of multi-specialty care has made important contributions to the decades-long effort to improve cancer care. The National Cancer Institute expanded support for these efforts by including cancer care delivery research in the 2014 formation of the National Cancer Institute Community Oncology Research Program (NCORP). Cancer care delivery research is a multi-disciplinary effort to generate evidence-based practice change that improves clinical outcomes and patient well-being. NCORP scientists and community-based clinicians and organizations rapidly embraced the addition of this type of research into the network, resulting in a robust portfolio of observational studies and intervention studies within the first 5 years of funding. This commentary describes the initial considerations in conducting this type of research in a network previously focused on cancer prevention, control, and treatment studies; characterizes the protocols developed to date; and outlines future directions for cancer care delivery research in the second round of NCORP funding.

The emergence of personal growth amongst healthcare professionals who care for dying children

2017 ◽  
Vol 16 (3) ◽  
pp. 298-307 ◽  
Author(s):  
Laura Beaune ◽  
Barbara Muskat ◽  
Samantha J. Anthony
Keyword(s):  
Compassion Fatigue ◽  
Personal Growth ◽  
Healthcare Professionals ◽  
Qualitative Interviews ◽  
Secondary Analysis ◽  
Well Being ◽  
Three Dimensions ◽  
Positive Effects ◽  
Dying Children ◽  
The Impact

ABSTRACTObjective:Compassion fatigue, burnout, and vicarious traumatization are prominent topics in the current literature on the impact of the rewarding but challenging work of healthcare professionals who care for patients with life-limiting illnesses. The positive effects of caregiving constitute a newly emerging outcome that has been relatively unexplored in the pediatric literature, and yet they may play an important role in contributing to the satisfaction and well-being of the healthcare professionals who care for children who have a life-limiting illness.Method:This paper reports the results of a secondary analysis of qualitative interview transcripts that explored the experiences of hospital-based pediatric healthcare providers caring for children with varied life-limiting illnesses. In-depth qualitative interviews were conducted with 25 healthcare professionals (9 social workers, 8 nurses, and 8 physicians). The majority of participants were women (80%), with an age range between 20 and 60 years, and most (84%) had the experience of caring for more than 15 dying children. Thematic analysis was conducted using interpretive description and constant comparison.Results:Every healthcare professional interviewed experienced personal growth as a result of their providing care for dying children. Three dimensions of personal growth were most consistently reported: (1) new or altered life perspectives, (2) enhanced personal resources, and (3) benevolence.Significance of results:A deeper understanding of the phenomenon of personal growth could help healthcare organizations to implement innovative approaches that would counterbalance compassion fatigue, and thereby enhance both healthcare provider well-being and child and family outcomes.

Effective Communication for Newly Diagnosed Pediatric Patients With Cancer: Considerations for the Patients, Family Members, Providers, and Multidisciplinary Team

2019 ◽  
pp. 573-581 ◽  
Author(s):  
Sarah Dobrozsi ◽  
Amy Trowbridge ◽  
Jennifer W. Mack ◽  
Abby R. Rosenberg
Keyword(s):  
Communication Skills ◽  
Pediatric Cancer ◽  
Multidisciplinary Team ◽  
Cancer Care ◽  
Care Delivery ◽  
Effective Communication ◽  
Well Being ◽  
Medical Team ◽  
High Quality ◽  
Personalized Care

Hearing that a child has been diagnosed with cancer is invariably difficult for both patients and their caregivers. Effective communication among patients, caregivers, and medical teams is necessary not only to deliver information and facilitate cancer care delivery but also to support patient and family coping and well-being. In this review, we focus on early communication in pediatric oncology care to (1) highlight the importance of communication between clinicians and patients and within the medical team and (2) describe resources and opportunities for clinicians to improve communication skills. For example, communication between patients and the medical team has several core functions, including the development of shared knowledge and decision-making and the formation of a therapeutic relationship. High-quality communication, regardless of the news being shared, supports and facilitates patient and parent adjustment to diagnosis, hope, and trust. Communication within the medical team supports the delivery of high-quality, personalized care. Despite these critical roles of communication in pediatric cancer care and evidence suggesting communication skills can be learned, formal training is limited. Resources include educational efforts, practical tools, and specific strategies to enhance systematic multidisciplinary team communication. Taken together, continued recognition of the importance of communication in pediatric cancer care has the potential to improve patient, family, and clinician experiences.

scholarly journals American Society of Clinical Oncology Road to Recovery Report: Learning From the COVID-19 Experience to Improve Clinical Research and Cancer Care

2021 ◽  
Vol 39 (2) ◽  
pp. 155-169
Author(s):  
Nathan A. Pennell ◽  
Melissa Dillmon ◽  
Laura A. Levit ◽  
E. Allyn Moushey ◽  
Ajjai S. Alva ◽  
...  
Keyword(s):  
Clinical Research ◽  
Cancer Care ◽  
Care Delivery ◽  
Well Being ◽  
Lessons Learned ◽  
Scientific Integrity ◽  
High Quality ◽  
Quality Cancer Care ◽  
American Society ◽  
Made In

This report presents the American Society of Clinical Oncology’s (ASCO’s) evaluation of the adaptations in care delivery, research operations, and regulatory oversight made in response to the coronavirus pandemic and presents recommendations for moving forward as the pandemic recedes. ASCO organized its recommendations for clinical research around five goals to ensure lessons learned from the COVID-19 experience are used to craft a more equitable, accessible, and efficient clinical research system that protects patient safety, ensures scientific integrity, and maintains data quality. The specific goals are: (1) ensure that clinical research is accessible, affordable, and equitable; (2) design more pragmatic and efficient clinical trials; (3) minimize administrative and regulatory burdens on research sites; (4) recruit, retain, and support a well-trained clinical research workforce; and (5) promote appropriate oversight and review of clinical trial conduct and results. Similarly, ASCO also organized its recommendations regarding cancer care delivery around five goals: (1) promote and protect equitable access to high-quality cancer care; (2) support safe delivery of high-quality cancer care; (3) advance policies to ensure oncology providers have sufficient resources to provide high-quality patient care; (4) recognize and address threats to clinician, provider, and patient well-being; and (5) improve patient access to high-quality cancer care via telemedicine. ASCO will work at all levels to advance the recommendations made in this report.

ACOFP Member Survey on Physician Wellness and Preventative Measures for Protection

2020 ◽  
pp. 16-19
Author(s):  
Jesse Shaw ◽  
Katherine Lincoln ◽  
Andrew Crow
Keyword(s):  
Task Force ◽  
Well Being ◽  
The United States ◽  
Daily Work ◽  
Physician Wellness ◽  
Preventative Measures ◽  
Personal Consequences ◽  
Organizational Attention ◽  
Physician Support ◽  
The Impact

The current medical landscape highlights that physicians are experiencing an unprecedented epidemic of burnout. National studies show that at least 50% of physicians practicing in the United States are experiencing this harmful, detrimental disorder. This not only leads to personal consequences but potentially adverse patient events. As studies suggest, family medicine physicians are at the highest risk. To evaluate the impact of this effect on its current members and to establish strategies to promote wellness, the American College of Osteopathic Family Physicians (ACOFP) appointed a Task Force on Physician Wellness. Data was collected by a voluntary internal survey between March 21 and April 7, 2019, distributed to all ACOFP members. A total of 133 members completed the survey. Nearly half (47%) of respondents admitted to experiencing burnout symptoms. The factors that influenced burnout the most were the burden of non-clinical/administrative work and the inefficient/burdensome electronic medical record. The most protective elements to combat burnout are having a supportive spouse/partner/family member and recognizing the meaning of their daily work. A transition must occur to focus on health instead of the disease of our physicians. Individual and organizational attention must be placed on the physical, mental and social well-being of physicians. In the creation of this task force, ACOFP has begun to create educational references, provide live CME and generate conversational networks for physician support.

scholarly journals Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040503 ◽  
Author(s):  
Cecilia Vindrola-Padros ◽  
Lily Andrews ◽  
Anna Dowrick ◽  
Nehla Djellouli ◽  
Harrison Fillmore ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Care Delivery ◽  
Well Being ◽  
Media Analysis ◽  
Routine Practice ◽  
Front Line ◽  
Framework Analysis ◽  
Daily Work ◽  
Line Staff ◽  
The Uk

ObjectiveThe COVID-19 pandemic has set unprecedented demand on the healthcare workforce around the world. The UK has been one of the most affected countries in Europe. The aim of this study was to explore the perceptions and experiences of healthcare workers (HCWs) in relation to COVID-19 and care delivery models implemented to deal with the pandemic in the UK.MethodsThe study was designed as a rapid appraisal combining: (1) a review of UK healthcare policies (n=35 policies), (2) mass media and social media analysis of front-line staff experiences and perceptions (n=101 newspaper articles, n=1 46 000 posts) and (3) in-depth (telephone) interviews with front-line staff (n=30 interviews). The findings from all streams were analysed using framework analysis.ResultsLimited personal protective equipment (PPE) and lack of routine testing created anxiety and distress and had a tangible impact on the workforce. When PPE was available, incorrect size and overheating complicated routine work. Lack of training for redeployed staff and the failure to consider the skills of redeployed staff for new areas were identified as problems. Positive aspects of daily work reported by HCWs included solidarity between colleagues, the establishment of well-being support structures and feeling valued by society.ConclusionOur study highlighted the importance of taking into consideration the experiences and concerns of front-line staff during a pandemic. Staff working in the UK during the COVID-19 pandemic advocated clear and consistent guidelines, streamlined testing of HCWs, administration of PPE and acknowledgement of the effects of PPE on routine practice.

scholarly journals De-implementing Low-Value Care in Cancer Care Delivery: A Systematic Review

2021 ◽  
Author(s):  
Amir Alishahi Tabriz ◽  
Kea Turner ◽  
Alecia Clary ◽  
Young-Rock Hong ◽  
Oliver T Nguyen ◽  
...  
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
Assessment Tools ◽  
System Level ◽  
Future Research ◽  
Unintended Effects ◽  
Inclusion Criteria ◽  
Framework Analysis ◽  
Healthcare Organizations ◽  
The Usa

Abstract Background Accumulating evidence suggests that interventions to de-implement low-value services are urgently needed. While medical societies and educational campaigns such as Choosing Wisely have developed several guidelines and recommendations pertaining to low-value care, little is known about interventions that exist to de-implement low-value care in oncology settings. We conducted this review to summarize the literature on interventions to de-implement low-value care in oncology settings, define an agenda for future research, and inform the literature about opportunities for additional work. Methods We systematically reviewed the published literature in PubMed, Embase, CINAHL Plus, and Scopus. We screened the retrieved abstracts for eligibility against inclusion criteria and conducted a full-text review of all eligible studies on de-implementation interventions in cancer care delivery. We used the framework analysis approach to summarize included studies' key characteristics including design; outcome(s); type of cancer, objective(s); and de-implementation interventions, determinants of the use ofthe use of de-implementation interventions, and their effectiveness. We assessed included studies’ quality using the NIH Quality Assessment Tools. Results Out of 2,793 studies, 13 met our inclusion criteria. Included studies have been published between 2003 and 2020, and the majority (n = 9) of them were conducted in the USA. They covered several cancer types including prostate cancer (n = 4), multiple cancers (n = 3), hematologic cancers (n = 3), lung cancer (n = 1), breast cancer (n = 1), and gastrointestinal cancer (n = 1). Four studies were focused on de-implementing low-value diagnostic tests, six studies focused on de-implementing low-value treatment procedures, and three studies focused on low-value screening services. Most of the de-implementation interventions (n = 11) were effective in reducing low-value care. No study assessed the determinants of the use of de-implementation interventions. Conclusions This review showed that to accelerate the reduction of low-value cancer care, instead of solely relying on diffusion new evidence and guidelines (i.e., passive de-implementation), healthcare organizations should initiate de-implementation interventions and implement strategies purposefully aimed at reducing low-value care (i.e., active de-implementation). Additionally, future research should include a broader range of variables such as patients’ perspectives and preferences, unintended effects of de-implementing low-value care, and system-level factors when studying de-implementation.

scholarly journals Playful strategies to foster the well-being of pediatric cancer patients in the Brazilian Unified Health System: a design thinking approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leandro Miletto Tonetto ◽  
Valentina Marques da Rosa ◽  
Priscila Brust-Renck ◽  
Megan Denham ◽  
Pedro Marques da Rosa ◽  
...  
Keyword(s):  
Health System ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Cancer Care ◽  
Design Thinking ◽  
Care Delivery ◽  
Well Being ◽  
Subjective Well Being ◽  
Unified Health System ◽  
Pediatric Cancer Patients

Abstract Background Cancer care can negatively impact children’s subjective well-being. In this research, well-being refers to patients’ self-perception and encompasses their hospital and care delivery assessment. Playful strategies can stimulate treatment compliance and have been used to provide psychosocial support and health education; they can involve gamification, virtual reality, robotics, and healthcare environments. This study aims to identify how playfulness, whenever applicable, can be used as a strategy to improve the subjective well-being of pediatric cancer patients in the Brazilian Unified Health System. Methods Sixteen volunteers with experience in pediatric oncology participated in the study. They were physicians, psychologists, child life specialists, and design thinking professionals. They engaged in design thinking workshops to propose playful strategies to improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Data collection consisted of participatory observations. All activities were video recorded and analyzed through Thematic Analysis. The content generated by the volunteers was classified into two categories: impact of cancer care on children’s self-perception and children’s perceptions of the hospital and the care delivery. Results Volunteers developed strategies to help children deal with time at the hospital, hospital structure, and care delivery. Such strategies are not limited to using playfulness as a way of “having fun”; they privilege ludic interfaces, such as toys, to support psychosocial care and health education. They aim to address cancer and develop communication across families and staff in a humanized manner, educate families about the disease, and design children-friendly environments. Volunteers also generated strategies to help children cope with perceptions of death, pain, and their bodies. Such strategies aim to support understanding the meaning of life and death, comprehend pain beyond physicality, help re-signify cancer and children’s changing bodies, and give patients active voices during the treatment. Conclusions The paper proposes strategies that can improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Such strategies connect children’s experiences as inpatients and outpatients and may inform the implementation of similar projects in other developing countries.

scholarly journals Cancer Care Delivery Research: Building the Evidence Base to Support Practice Change in Community Oncology

2015 ◽  
Vol 33 (24) ◽  
pp. 2705-2711 ◽  
Author(s):  
Erin E. Kent ◽  
Sandra A. Mitchell ◽  
Kathleen M. Castro ◽  
Darren A. DeWalt ◽  
Arnold D. Kaluzny ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Care Delivery ◽  
Well Being ◽  
Evidence Base ◽  
Care Quality ◽  
Practice Change ◽  
Health Technologies ◽  
Oncology Research ◽  
Community Oncology

Understanding how health care system structures, processes, and available resources facilitate and/or hinder the delivery of quality cancer care is imperative, especially given the rapidly changing health care landscape. The emerging field of cancer care delivery research (CCDR) focuses on how organizational structures and processes, care delivery models, financing and reimbursement, health technologies, and health care provider and patient knowledge, attitudes, and behaviors influence cancer care quality, cost, and access and ultimately the health outcomes and well-being of patients and survivors. In this article, we describe attributes of CCDR, present examples of studies that illustrate those attributes, and discuss the potential impact of CCDR in addressing disparities in care. We conclude by emphasizing the need for collaborative research that links academic and community-based settings and serves simultaneously to accelerate the translation of CCDR results into practice. The National Cancer Institute recently launched its Community Oncology Research Program, which includes a focus on this area of research.

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