Abstract
Burnout afflicts 35% to 44% of pediatric oncology physicians, nurses, and interprofessional staff and is related to excessive workloads and emotional exhaustion. Conversely, a healthy work environment is a protective factor for burnout among physicians and nurses. Meaningful recognition is a published standard necessary for creating a healthy work environment. This study aimed to reduce staff burnout through firgun, defined as a heartfelt way to express accomplishments of another person. Pediatric oncology staff completed a firgun educational module and logged acts of firgun during a 3-month study period. Validated measures assessing burnout, workplace civility, well-being, work-life balance, and perceived stress were completed before and after the intervention. Descriptive statistics were reported for participant demographics, firgun frequency, and survey scores at baseline and after the firgun intervention. Mixed-effects analysis of variance models of each survey in relation to pre- and post-intervention time points were used to assess pre-to-post changes. One hundred twelve participants completed baseline assessments, 88 completed the firgun education module, 62 logged firgun events, and 64 completed the follow-up measures. Logging of firgun decreased over time; however, significant improvements were noted on the workplace civility index scores (pre-intervention: 66% high civility, post pre-intervention: 77% high civility; P = .006); Maslach Burnout Inventory (MBI) depersonalization subscale (21.6% to 9.4%; P = .0001); and World Health Organization Well-Being Index (WHO-5) well-being item (28.4% poor to 15.6% poor; P = .0001). A trend of improvement in reported burnout on MBI was also found, from 48.9% to 36.5% (OR, 0.57; P = .09). In a single-arm cohort study of pediatric oncology interprofessional staff, the use of firgun—a simple, low-cost, and scalable intervention—was associated with improved workplace civility and well-being as well as reduced burnout. These preliminary findings suggest that firgun may positively impact the pediatric oncology work environment and staff wellness. However, the decline in logged firgun acts over time raises concerns about the sustainability of this effect. Future research should involve more rigorous testing with a well-defined control group to provide stronger evidence of its effectiveness.
DOI
https://doi.org/10.52519/ACEQI.25.1.2.a2
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Recommended Citation
Moody K, Stein J, Levine D, Madni A, Andersen CR, Heaton A, Rajan AP, Petropoulos D, Wang J, Kramer D. The Use of Firgun to Improve Burnout and Workplace Civility in a Pediatric Cancer Center. Advances in Cancer Education and Quality Improvement. 2025; 1(2). doi: https://doi.org/10.52519/ACEQI.25.1.2.a2.
Supplemental Data: Statistical Methods