Nurses: The Unheard Voice in Addressing EHR Burnout

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Effective Ways to Handle Patient Complaints

By Toni Laracuente, RN, BSN

The World Health Organization has designated 2020 as the International Year of the Nurse and Midwife to celebrate their vital contributions to healthcare across the globe. Nursing is the largest healthcare profession and nurses comprise more than 40% of the healthcare workforce.

Despite their large numbers – more than 3.8 million in the United States – nurses are often overlooked when it comes to one of healthcare’s most alarming recent trends: The escalating levels of workplace stress and burnout among healthcare professionals. Burnout conversations often focus on physicians and overlook nurses, even though both roles share high degrees of stress triggered by administrative burdens, demands to see more patients in less time, and the use of poorly designed EHRs. 

In this year of the nurse, and especially as we sit in the middle of the COVID-19 pandemic, it is timely to escalate attention on healthcare burnout by seeking input and collaboration from nursing professionals. 

Fixing EHRs to support nurses in care delivery

Nurses are heavy users of EHRs, but EHRs are rarely aligned with nursing workflows. Inefficient EHRs can be a significant source of frustration because they can negatively impact productivity and interfere with the nurse-patient relationship. The burden of EHRs, along with nurses’ ever-expanding administrative workloads, drives professional burnout and ultimately impacts healthcare performance, staff recruitment and retention, and the patient experience. 

By including nurse leaders and front-line staff as key stakeholders, subject matter experts and patient advocates, nurses can provide invaluable input for EHR project planning, clinical governance and system design.  Nurses can provide project leadership, representing and educating their peers and sharing their expertise on workflow requirements, which vary significantly depending on role, department and specialty. EHRs generally have siloed, generic workflows, but with nurse input, implementation teams can create customized and efficient processes that users will embrace. 

Nurses can also advise when EHR inefficiencies stand in the way of delivering direct patient care. A common source of frustration is the inability to quickly access information for clinical decision making. Nurses waste considerable time searching through disconnected data silos to find critical details at the point of care. Implementation teams should seek tools that transform data into clean, well-organized information that is available within end-user workflow, giving nurses more time to interact with patients.

Nurses also need solutions that facilitate efficient interdisciplinary communication. Regardless of role, all team members need access to multidisciplinary treatment information to stay updated on a patient’s status. This can be difficult when users across different care settings use different clinical systems. By embracing solutions that provide seamless, bi-directional interoperability between disparate systems, organizations can optimize communication and improve care collaboration. 

Embracing technology that supports the nurse experience

By 2022, we could face a shortage of 1.1 million registered nurses as the population ages and seasoned nurses retire. It’s thus imperative that we embrace technology that supports the nurse experience, reduces frustration and minimizes administrative burdens.

Fortunately, new and emerging technologies such as artificial intelligence (AI) and clinical decision support solutions can enhance existing EHRs by complementing nurse workflows, freeing nurses to use their time and skills more effectively.

Nursing leadership can help identify the highest priority issues where technologies can deliver the greatest benefit by considering the potential impact on patients and staff. 

A few high impact, results driven solutions include: 

Care planning and documentation. Creating and updating care plans and documentation can be tedious and time-consuming. The process can be automated using AI-based clinical decision support tools that quickly build care plans that are evidence-based, multidisciplinary and patient-focused, also meeting compliance and team communication needs. Rather than spending time inputting data, nurses can simply review the final product and edit by exception. 

Enhanced patient care. Clinical AI, analytics, decision support tools and similar technologies support nurses by providing relevant practice guidelines in real time at the point of care. Such solutions facilitate informed, faster decision making, audit-proof documentation and safe guidelines for high-quality, evidence-based care. Users can find specific information more quickly and spend less time entering repetitive, non-coded text. Precisely coded clinical documentation is created automatically to facilitate advanced reporting, operational planning, research, and compliance review.

Stress and staffing challenges. In the face of the worsening nursing shortage, technology can offer relief by augmenting (not replacing) the skills of less-experienced nurses and other patient care staff. For example, decision support tools that use evidence-based practices can guide a nurse to decide “what to do next” when a patient’s status is deteriorating or is admitted with a rare diagnosis. Providing in-workflow guidance can increase staff confidence and reduce stress levels.  

Addressing the nursing and healthcare workforce burnout crisis requires a comprehensive organizational approach, of which technology is an enabler—not a panacea. However, we can significantly improve the working lives of nurses, doctors and patient care staff with the strategic use of current and evolving technologies. 

As we celebrate nurses throughout the International Year of the Nurse and Midwife, let’s recognize, empower, and value their invaluable contributions at every level of care delivery.  

Toni Laracuente, RN, is the chief nursing officer of Medicomp Systems, a provider of clinician-driven point-of care solutions that fix EHRs. 

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