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要解决肿瘤学中的倦怠问题,我们必须着眼于团队:对组织科学方法的思考。

To Address Burnout in Oncology, We Must Look to Teams: Reflections on an Organizational Science Approach.

机构信息

Embry-Riddle Aeronautical University - Worldwide, Daytona Beach, FL.

Clemson University, Clemson, SC.

出版信息

JCO Oncol Pract. 2020 Apr;16(4):e377-e383. doi: 10.1200/JOP.19.00631. Epub 2020 Feb 19.

Abstract

PURPOSE

Despite decades of effort, burnout among physicians remains elevated compared with that of other working populations, and it yields catastrophic consequences, including medical errors and physician suicide. Burnout leaves oncologists feeling like they are alone, but this is not the case-it affects everyone. To effectively address burnout, it is not enough to look only at oncologists; instead, we must include all those involved in the delivery of cancer care. With this aim, we present an overview of the organizational science strategies and initial evidence for the value of a comprehensive, team-focused approach to addressing oncology provider burnout.

METHODS

We describe the development of a team-focused burnout intervention approach, implemented for oncology providers, which focuses on the importance of encouraging communication and psychological safety to reduce feelings of isolation and fragmentation. We discuss the initial findings from 1 such team-based initiative currently underway within an academic medical center, presenting data from 409 cancer care providers embedded in 30 oncology units participating in this intervention approach.

RESULTS

Preliminary results demonstrate that units that integrated a team-focused intervention for burnout reported significantly higher levels of teamwork and lower levels of burnout. We also describe lessons learned and recommendations for implementing this type of intervention on the basis of best practices from organizational science.

CONCLUSION

This approach can positively affect the delivery of cancer care, interprofessional relationships among oncology staff, and the well-being of both patients and providers. Treating physician burnout alone will treat 1 symptom of the overall issue of burnout in oncology. As burnout pulls oncology clinicians apart, our solution must be to bring them together.

摘要

目的

尽管已经努力了几十年,但与其他职业人群相比,医生的职业倦怠仍然居高不下,而且会产生灾难性的后果,包括医疗失误和医生自杀。职业倦怠让肿瘤医生感到孤立无援,但事实并非如此——它影响着每一个人。为了有效地应对职业倦怠,仅仅关注肿瘤医生是不够的;相反,我们必须将所有参与癌症护理的人员都包括进来。基于这一目的,我们概述了组织科学策略,并初步证明了采取全面、以团队为重点的方法来解决肿瘤学提供者职业倦怠问题的价值。

方法

我们描述了一种针对肿瘤学提供者的以团队为重点的倦怠干预方法的开发,该方法侧重于鼓励沟通和心理安全的重要性,以减少孤立感和碎片化感。我们讨论了目前在一家学术医疗中心进行的一项基于团队的倡议的初步结果,该倡议从参与该干预方法的 30 个肿瘤学单位中的 409 名癌症护理提供者那里获得了数据。

结果

初步结果表明,整合了针对倦怠的以团队为重点的干预措施的单位报告了更高水平的团队合作和更低水平的倦怠。我们还根据组织科学的最佳实践,描述了实施这种干预措施的经验教训和建议。

结论

这种方法可以积极影响癌症护理的提供、肿瘤学工作人员之间的跨专业关系以及患者和提供者的福祉。单独治疗医生的职业倦怠只会治疗肿瘤学中整体倦怠问题的 1 个症状。随着职业倦怠将肿瘤学临床医生分开,我们的解决方案必须将他们团结在一起。

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