A projected shortage of hematopoietic cell transplantation (HCT) health professionals was identified as a major issue during the National Marrow Donor Program/Be The Match System Capacity initiative. Work-related distress and work-life balance were noted to be potential barriers to recruitment/retention. This study examined these barriers and their association with career satisfaction across HCT disciplines. A cross-sectional, 90-item, web-based survey was administered to advanced practice providers, nurses, physicians, pharmacists, and social workers in 2015. Participants were recruited from membership lists of 6 professional groups. Burnout (measured with the Maslach Burnout Inventory subscales of emotional exhaustion and depersonalization) and moral distress (measured by Moral Distress Scale Revised) were examined to identify work-related distress. Additional questions addressed demographics, work-life balance, and career satisfaction. Of 5759 HCT providers who received an individualized invitation to participate, 914 (16%) responded; 627 additional participants responded to an open link survey. Significant differences in demographic and practice characteristics existed across disciplines (P<.05). The prevalence of burnout differed across disciplines (P<.05) with an overall prevalence of 40%. Over one-half of pharmacists had burnout, whereas social workers had the lowest prevalence at less than one-third. Moral distress scores ranged from 0 to 336 and varied by discipline (P<.05); pharmacists had the highest mean score (62.9 +/- 34.8) and social workers the lowest (42.7 +/- 24.4). In multivariate and univariate analyses, variables contributing to burnout varied by discipline; however, moral distress was a significant contributing factor for all providers. Those with burnout were more likely to report inadequate work-life balance and a low level of career satisfaction; however, overall there was a high level of career satisfaction across disciplines. Burnout, moral distress, and inadequate work-life balance existed at a variable rate in all HCT disciplines, yet career satisfaction was high. These results suggest specific areas to address in the work environment for HCT health professionals, especially the need for relief of moral distress and a greater degree of personal time. As the creation of healthy work environments is increasingly emphasized to improve quality care and decrease costs, these findings should be used by HCT leadership to develop interventions that mitigate work-related distress and in turn foster recruitment and retention of HCT providers. (C) 2017 American Society for Blood and Marrow Transplantation.

Clinical social workers are psychosocial care experts who provide interventions that aim to address the emotional, relational, financial, and logistical challenges that arise throughout the hematopoietic cell transplantation (HCT) treatment and recovery process. Interventions that contribute to better patient outcomes can include cognitive behavioral therapy and counseling for adaptation to illness, family planning for 24/7 caregiver availability and strategies to support patient activities of daily living, instruction on guided imagery and relaxation techniques for symptom management and to decrease anxiety, psychoeducation on the treatment trajectory, and linkage with financial resources. A Social Work Workforce Group (SWG) was established through the System Capacity Initiative, led by the National Marrow Donor Program/Be The Match, to characterize the current social work workforce capacity and challenges. The SWG conducted a web-based survey of Ha clinical social workers in the United States. The response rate was 57% (n = 90), representing 76 transplant centers. Survey results indicated that the clinical social worker role and scope of practice varies significantly between centers; less than half of respondents reported that their clinical social work expertise was used to its fullest potential. With an estimated 3-fold increase in HCT patient volume by 2020, the need for specialized psychosocial health services will increase. The SWG makes recommendations to build capacity for the psychosocial care of HO' patients and to more fully integrate the social worker as a core member of the HO' team. The SWG created a Blood and Marrow Transplant (BMT) Clinical Social Worker role description that can be used by transplant centers to educate healthcare professionals, benchmark utilization of clinical social workers, and improve comprehensive psychosocial health programs. (C) 2018 American Society for Blood and Marrow Transplantation.

The projected shortage of hematopoietic cell transplantation (HCT) health professionals was identified as a major issue during the National Marrow Donor Program's System Capacity Initiative. In response, a multi-disciplinary working group formed to address recruitment/retention issues for HCT providers. Care of HCT recipients can be physically and emotionally challenging, and the need to address work-related distress and work-life balance was identified. This study examines these barriers as well as their association with career satisfaction across HCT disciplines. A cross-sectional, 90-item, web-based survey was administered to advanced practice providers (APP), nurses, physicians, pharmacists, and social workers in 2015. Participants were recruited from membership lists of 6 professional groups (Figure 1). The dimensions of burnout (as measured by Maslach Burnout Inventory [MBI] subscales of emotional exhaustion [EE] and depersonalization [DP]) and moral distress (as measured by Moral Distress Scale – Revised) were examined to identify work-related distress. Additional questions addressed work-life balance, career satisfaction, and demographics. Of 5,759 HCT providers who received individualized invites to participate, 914 responded (16%); additional participants responded to an open link survey (Figure 1). Significant differences in demographic and practice characteristics were found across discipline (P < 0.05). Physicians reported the highest percentage of working > 60 hours per week. APPs, physicians, and pharmacists had higher percentages of burnout (Table 1). Moral distress varied by discipline (P < 0.05); pharmacists had the highest mean score (62.9±34.8) and social workers the lowest (42.7±24.4). Among the groups, only 31% physicians agreed they had enough time for personal/family life (Figure 2), yet 81% were satisfied with their career in HCT (Figure 3). Although limited by size and response rate, study results suggest specific areas to address in the work environment for HCT health professionals by discipline, especially the need for personal time and relief of emotional exhaustion. As the creation of healthy work environments is increasingly emphasized in healthcare to improve quality care and decrease costs, these findings can be used by HCT leadership to develop interventions which mitigate work-related distress, and in turn foster recruitment and retention of HCT providers.Figure 2Reponses to statement, "My work schedule leaves me enough time for personal/family life," by disciplineView Large Image Figure ViewerDownload Hi-res image Download (PPT)Reponses to statement, "I am satisfied with my career in HCT," by discilineView Large Image Figure ViewerDownload Hi-res image Download (PPT)Table 1MBI-EE/DP Scores measuring bumout by disciplineMBI Sub scaleAPPn=255(%)Nursen=763(%)Physiciann=330(%)Pharmacistn=95(%)Social Workern=98 (%)EE ScoreLow (0-16)2032351626Medium (17-26)3635323546High (27-54)4433334929DP ScoreLow (0-8)8379737491Medium (9-13)111418188High (14-30)671081BurnoutNo5562594770Yes4538415330Note: ≥ 27 on EE score and/or ≥ 10 on DP score is defined as burnout. Open table in a new tab

evaluated and discussed.The results will be shared with the pain team experts in order to plan and evaluate further needed education.In practice, is pain always what the patient says it is?