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KLAS’ Taylor Davis on Physician Burnout & COVID19

Taylor Davis, VP, Strategy & Development, KLAS

As COVID-19 continues to spread across the world, health systems are becoming more and more overwhelmed by the number of infected people, which is quickly surpassing health systems’ capacities for treatment. The current pandemic is also exacerbating an already prevalent issue within healthcare: burnout.

The Arch Collaborative has found that about 28 percent of providers and 25 percent of nurses report burnout. These numbers are concerning, not only because burnout impacts people’s ability to deliver care; it also because it increases cost and turnover.

It is important for health systems to tackle all the issues that lead to burnout. As part of our survey, we asked clinicians to indicate what they felt drove their burnout. The top three reasons they cited are all related to each other: the after-hours workload, the amount of time spent on bureaucratic tasks, and the EHR. Helping organizations measure their providers’ experience with EHRs is at the core of what the Arch Collaborative does. Here are a few things that organizations can focus on to alleviate the strain that EHRs put on provides and nurses.

Proficiency

A key element of decreasing burnout is ensuring that providers and nurses are highly proficient with the software they are using. That may seem intuitive, but one thing that the Arch Collaborative survey asks people is whether they feel strong user mastery, and a lot of people can’t say that they are confident in their ability to use the software.

In order to combat this lack of proficiency, many organizations have developed programs that specifically enable users to become efficient with their EHR. For example, Kaiser Permanente in Oregon has created a program called Pathways to Proficiency in which providers go off-site every few years to receive intensive training specifically around the EHR.

However, if organizations are daunted by the cost that such a program would require, there are still many ways to encourage proficiency that don’t cost anything. Sharing best practices is a great way to create transparency and mastery so that everyone can work together in a better way.

Personalization

Organizations also need to examine the workflows that they have in place and ensure that those are engineered to meet people’s needs. If workflows aren’t aligned with users’ needs, they may not actually use those workflows.

Different areas within the hospital will naturally have different requirements in terms of dashboards and screens. Changes can come from the organizational level or the individual level, but the software should be set up so that data is available to users in the way that they like.

Legacy Health uses a program similar to the one at Kaiser Permanente, which teaches personalization to providers so that they can create and use the configuration that best meets their needs. Having the right configuration can drastically affect the lives of users. One Legacy Health provider said that the program improved their overall mental and physical health, proving just how deep the impacts of burnout can be and how important it is to alleviate them.

Shared Ownership

Another major strategy for alleviating burnout is creating a strong model of shared ownership. Health systems need to listen to their employees’ voices and make changes based on the things they say. Similarly, providers should have confidence in the EHR so that even if providers don’t currently like it, they can still know that their organization will work with them to make the system better.

After Rush University received the measurement of their EHR performance from the Arch Collaborative, they quickly sent out a flyer to their providers detailing their approach for improving EHR satisfaction and use. In addition to addressing issues with proficiency and personalization, Rush University also focused on communicating with providers and creating a sense of shared ownership within the organization.

Rush University’s work paid off, as they were able to jump to the top percentiles within the Arch Collaborative’s findings. While many factors play part in an increase like that, communicating with providers can lay the foundation for change and help them feel part of the EHR experience.

More Than the EHR

EHR functionality and providers’ abilities to use that functionality are major contributing factors to burnout. And while there is a strong correlation between EHR satisfaction and the level of burnout that providers experience, the correlation isn’t quite as strong as one might expect; the EHR likely accounts for less than 20 percent of burnout contributors.

Burnout is a problem that is caused by multiple factors, so naturally, the solution to burnout will need to involve multiple factors. Providers sacrifice a lot to take care of us, so we shouldn’t do them the disservice of assuming the EHR is the only factor contributing to their struggles.

The good news is that the EHR and other burnout factors can be resolved. KLAS encourages all organizations to examine their providers’ experiences and see how they can measure and collaborate to improve those experiences. Readers can also find more information about the strategies mentioned in this post by watching this video presentation.

Also, if organizations want to share their EHR experiences with KLAS, please consider participating in the Arch Collaborative.

[Taylor Davis is VP of Strategy & Development KLAS Enterprises. To follow him on Twitter, click here. For more information about KLAS, click here.]

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