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Cited by 4Healthcare professionals’ stress and burnoutOccupational Health and BurnoutStress and Burnout Research

Decreasing Burnout and Improving Work Environment: The Impact of Firgun on a Pediatric Hematopoietic Cell Transplant Team

Stein, Jerry, Madni, Arshia, Moody, Karen, Kramer, Deborah, Vaughn, Dagny, Bhatia, Shalini, Sellers, Janet, Snyder, Angela +3 more·2023·JCO Oncology Practice
DOI 10.1200/op.22.00299
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Abstract

PURPOSE: Oncology teams are challenged by BO, which may be alleviated by meaningful recognition. In this study, firgun—altruistic acknowledgment—was implemented on a pediatric hematopoietic cell transplant unit to evaluate its impact on staff and work environment. METHODS: In this longitudinal, mixed-methods pilot study, interdisciplinary inpatient hematopoietic cell transplant providers received web-based firgun education. Electronic administration of validated surveys occurred at baseline and 8 weeks, including Perceived Stress Scale, Professional Quality of Life Scale, Maslach Burnout Inventory, Workplace Civility Index, Areas of Work Life Survey, and WHO-5. Weekly e-mails reminded participants to practice and log firgun. Wilcoxon signed test for paired data compared pre/post results. Interviews conducted at project completion were coded using MaxQDA software. RESULTS: Forty-two participants enrolled; 25 completed pre/post surveys; eight were interviewed. At study end, participants reported feeling less nervous and stressed ( P = .008), and less difficulty coping ( P = .01; Perceived Stress Scale), while noting increased acknowledgment of others' work ( P = .04) and seeking constructive feedback ( P = .04; Workplace Civility Index). Marked BO was not evident overall on the Maslach Burnout Inventory; however, emotional exhaustion subscale mean (SD) scores improved from pre (19.4 [8.6]) to post (16 [6.3; P = .02]) and individual items illustrated decreased fatigue ( P = .008), frustration ( P = .04), and feeling “at the end of my rope” ( P = .001). Postintervention participants noted increased receipt of recognition ( P = .02; Areas of Work Life Survey), decreased feeling “bogged down” ( P = .02), decreased affective stress ( P = .04), and negative pre-occupations ( P = .04; Professional Quality of Life Scale). Qualitative analysis revealed themes of improved confidence at work and enhanced feelings of trust and teamwork. CONCLUSION: Firgun is a tool that can potentially reduce BO and stress in interdisciplinary providers, facilitate teamwork, and promote positive work environments in clinical oncology and beyond.

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Authors
Stein, J., Madni, A., Moody, K., Kramer, D., Vaughn, D., Bhatia, S., Sellers, J., Snyder, A., Lu, Z., Baker, J. N., & Levine, D. R.
Affiliations
  • Tel Aviv University (IL)
  • St. Jude Children's Research Hospital (US)
  • The University of Texas MD Anderson Cancer Center (US)
  • College of Mount Saint Vincent (US)
ORCID
Venue
JCO Oncology Practice
Publisher
American Society of Clinical Oncology (ASCO)
Published
2023-03
Volume
19
Issue
3
Pages
e365-e376
ISSN
  • 2688-1527 (ISSN-L)
  • 2688-1535
DOI
10.1200/op.22.00299
OpenAlex
W4312067147
Cited by
4
References
26
Citations by year
2026: 1 · 2025: 1 · 2024: 2
FWCI
0.86
Type
journal article
Language
en
Open access
closed
Locations
  • JCO Oncology Practice (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
  • Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
Keywords
burnout, work environment, workplace civility, emotional exhaustion, stress reduction, teamwork, professional quality of life
MeSH terms
Burnout, Professional, Child, Emotions, Humans, Pilot Projects, Quality of Life, Hematopoietic Stem Cell Transplantation

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