Table 4.

Final Consensus Competencies in the Category of System-Based Practice^a

C. Systems-Based Practice:
1. Navigating care:b
a. Effectively use resources for patients’ mental health services within the palliative care interdisciplinary team.
b. Facilitate referral to specialty mental health services outside of the palliative care interdisciplinary team when warranted.
c. Recognize the impact of social determinants of health (e.g., racism, socioeconomic status, housing) on mental health.
2. Sustainable Work Environment:
a. Appropriately seek consultation with peers or supervisors for challenging cases. (Psychological concept: Supervision)c
b. Identify signs and symptoms of clinician mental health needs such as burnout.d

^aThis category includes systems-level knowledge and skills that empower palliative care clinicians to provide high quality serious illness care to patients with varying mental health needs and to attend to their own wellbeing in doing so.

^bOrganizational headings are indicated in italics.

^cNote: we have listed psychological concepts as a key term to direct physicians’ further reading/learning, not as an indication that the concept is fully captured in this competency.

^dIncluded in final competencies with 74% of initial votes in the 7–9/9 range, erroneously not submitted for a second-round vote.