Addressing Palliative Care Clinician Burnout in Organizations: A Workforce Necessity, an Ethical Imperative

被引:55
作者
Harrison, Krista L. [1 ,2 ]
Dzeng, Elizabeth [3 ]
Ritchie, Christine S. [1 ]
Shanafelt, Tait D. [4 ]
Kamal, Arif H. [5 ]
Bull, Janet H. [6 ]
Tilburt, Jon C. [7 ]
Swetz, Keith M. [8 ,9 ]
机构
[1] Univ Calif San Francisco, Sch Med, Div Geriatr, San Francisco, CA USA
[2] San Francisco VA Med Ctr, 4150 Clement St VA181G, San Francisco, CA 94121 USA
[3] Univ Calif San Francisco, Sch Med, Div Hosp Med, San Francisco, CA USA
[4] Mayo Clin, Sch Med, Hematol, Rochester, MN USA
[5] Duke Univ, Duke Canc Inst, Durham, NC USA
[6] Four Seasons Compass Life, Flat Rock, NC USA
[7] Mayo Clin, Gen Internal Med, Rochester, MN USA
[8] Univ Alabama Birmingham, Birmingham, AL USA
[9] Birmingham Vet Affairs Med Ctr, Birmingham, AL USA
关键词
Burnout; moral distress; ethics; hospice; palliative care; WORK-LIFE BALANCE; DECISION-MAKING; MEDICAL ERRORS; HEALTH-CARE; OF-LIFE; PHYSICIAN TRAINEES; MORAL DISTRESS; HOSPICE; END; SATISFACTION;
D O I
10.1016/j.jpainsymman.2017.01.007
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. This is especially problematic in hospice and palliative care: patients are often frail, elderly, vulnerable, and complex; access to care is often outstripped by need; and demand for clinical experts will increase as palliative care further integrates into usual care. Efforts to mitigate and prevent burnout currently focus on individual clinicians. However, analysis of the problem of burnout should be expanded to include both individual-and systems-level factors as well as solutions; comprehensive interventions must address both. As a society, we hold organizations responsible for acting ethically, especially when it relates to deployment and protection of valuable and constrained resources. We should similarly hold organizations responsible for being ethical stewards of the resource of highly trained and talented clinicians through comprehensive programs to address burnout. (C) 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:1091 / 1096
页数:6
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