Association of Community Cancer Centers' Survey Finds Heavy Workloads and Workflow Inefficiencies are Top Concerns


ROCKVILLE, MD—Burnout among U.S. healthcare clinicians is a national concern. The National Academy of Medicine (NAM) established an Action Collaborative on Clinician Well-Being and Resilience in 2017 to raise awareness and identify approaches to reverse the trend. Burnout is described by NAM as “a syndrome characterized by a high degree of emotional exhaustion and depersonalization (i.e., cynicism), and a low sense of personal accomplishment at work.”

The potential for burnout among the members of the multidisciplinary cancer care team—from the front office staff to the clinicians to those who work behind the scenes—has long been recognized. Additional cause for concern is the projected “significant shortage” of medical and gynecologic oncologists in the United States, which the American Society of Clinical Oncology (ASCO) has been monitoring for more than a decade.

In a call to action, ACCC President 2018-2019 Tom Gallo, MS, MDA, chose Reflect, Renew, Reignite: Building a Resilient Oncology Team in Your Community for his president’s theme, challenging cancer programs to share their strategies for fostering well-being among all members of the cancer care team.

“Tapping into the collective experience of our membership, ACCC is working to create curated resources for positive change,” said ACCC President Gallo. “Just as we are committed to continually improving the patient experience, we must be committed to the well-being of those delivering that care.” Results from ACCC’s recently released 2018 Trending Now in Cancer Care survey show that cancer programs are taking steps to curb burnout by establishing staff recognition programs (56%), encouraging staff team building activities (50%), surveying staff periodically to assess professional well-being (49%), reimbursing staff for participating in professional development (44%), re-evaluating “who does what” to ensure the right person completes the right task (43%), and defining professional wellness as a strategic employee priority (41%).

However, survey findings reveal further opportunities to address staff concerns that may fuel future burnout. Asked about concerns that arise during a typical workday, three-fourths of respondents (75%) cited “workflow inefficiencies.” This was followed by “heavy workload” (67%) and “lack of work-life balance” (46%). By contrast only 29% reported “lack of reward and/or recognition” as an everyday concern.

Although “typical workday concerns” vary to some extent by role, across all team members both “heavy workload” and “workflow inefficiencies” were named as top concerns. (Team roles included in this survey question were cancer program administrators, physicians, advanced practitioners, nurses, pharmacy staff, radiation therapy clinical staff, clinical support staff, clinical or lay navigators, support service staff, and administrative staff.)

One-third of survey respondents (33%) report no physician turnover in the last 12 months, which is good news; however, 26% of respondents cite nursing turnover rates between 1 — 5% and 20% report turnover rates of 6 – 10%.

ACCC is creating a team well-being hub of resources at, and will be sharing successful strategies for building resilience and cancer care team well-being through an upcoming article series in Oncology Issues, the association journal. To hear directly from oncology program staff about burnout, ACCC invited members to take the Mini Z survey, a validated tool created by the American Medical Association to assess levels of stress among healthcare providers.

View an infographic with survey results here.

Read ACCC’s commitment letter as part of the National Academy Action Collaborative on Clinician Well-Being and Resilience here.

Learn more about the 2018 ACCC Trending Now in Cancer Care Survey here.

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