INTRODUCTION
Burnout is a psychological syndrome that develops as a prolonged
response to job-related stressors consisting of 3 key dimensions:
emotional exhaustion, depersonalization, and reduced personal
accomplishment.1 Causes and consequences of burnout
are being increasingly recognized as an important social issue,
especially in healthcare settings.2 A recent National
Academy of Medicine publication reported that burnout among healthcare
professionals negatively impacts healthcare quality and safety,
decreases patient satisfaction, increases staff turnover, reduces work
effort, and has negative financial implications for healthcare
organizations.3
Roth et al. reported burnout in 38% of pediatric oncologists in the US,
Canada, and 11 other countries.4 A meta-analysis of
burnout rates among oncology nurses showed 30%, 15%, and 35% having
high emotional exhaustion levels, high depersonalization levels, and
reduced personal accomplishment levels, respectively.5Thus, it is crucial to identify contributing (or causative) workplace
factors to develop effective interventions to prevent or reduce burnout
among clinicians in oncology settings.6
Halbesleben and Rathert observed that in physicians, higher
depersonalization levels were associated with lower patient satisfaction
and increased hospitalization recovery time,7 and
Shanafelt and colleagues found that physicians with burnout were more
likely to spend less time caring for patients.8Surgeons with higher burnout levels had higher rates of self-reported
medical errors;9 emergency room physicians with higher
burnout scores reported higher rates of suboptimal patient care (e.g.,
not treating a patient’s pain in a timely manner);10
Nurse burnout also negatively impacts patient care. Higher patient
urinary tract infection and surgical site infection rates have been
associated with burnout in nurses.11 Emotional
exhaustion and reduced personal accomplishment among nurses was
negatively associated with patient satisfaction,12 and
higher burnout levels among nurses were associated with lower peer-rated
quality of care.13
The impact of job demands and patient safety event (PSE) involvement on
burnout have been previously studied among healthcare workers but not
specifically in a multidisciplinary cohort of pediatric
hematology/oncology clinicians.14 The study objectives
were to: (1) assess the prevalence of burnout among inpatient and
ambulatory care nurses, physicians (MDs) and advanced practice providers
(APPs); (2) compare the differences in job demands, PSE involvement, and
burnout rates across groups; and (3) determine the impact of job demands
and PSE involvement on levels of burnout.