JMIR Publications

ABSTRACT

Background:

Up to 60% of healthcare providers experience one or more symptoms of burnout. Perceived clinician burden resulting in burnout arises from factors such as electronic health record (EHR) usability or lack thereof, perceived loss of autonomy, and documentation burden leading to less clinical time with patients. Burnout can have detrimental effects on healthcare quality and contributes to increased medical errors, decreased patient satisfaction, substance use, workforce attrition, and suicide.

Objective:

Objective:

This project is aimed at improving the user-centered design of the EHR by obtaining direct input from clinicians about deficiencies. Fixing identified deficiencies have the potential to increase user-centered design, thereby increasing satisfaction by reducing her-induced burnout.

Methods:

Quantitative and qualitative data will be obtained from clinician-EHR users. The input will be received through a survey built in to a REDCAP database via a link embedded in the home page of the EHR. The REDCAP data will be analyzed in two main dimensions based on nature of the input and what section of the EHR is affected and on what is required to fix the issue(s). Identified issues will then be escalated to relevant stakeholders responsible for rectifying the problems identified. Data analysis, project evaluation, and lessons learned from the evaluation will be incorporated in a plan-do-study-act (PDSA) manner every eight weeks.

Results:

The pilot phase of the study will begin in November 2020 in the Gastroenterology Department at The Mount Hospital, which includes 39 physicians and 15 nurses. The pilot is expected to run over a four-to-six month period. The results of the REDCAP data analysis will be released within one month of completing the pilot phase. We will analyze the nature of queries received and the impact of rectified issues on the clinician-EHR user. It is expected that the results will reveal which sections of the EHR have the highest deficiencies while also highlighting issues about workflow difficulties. Perceived impact of the project on provider engagement, patient safety, and workflow efficiency will also be captured by survey and other qualitative methods where possible.

Conclusions:

The project aims to improve user-centered design of the EHR by soliciting direct input from clinician-EHR users. The ultimate goal is to improve efficiency, reduce EHR inefficiencies with the possibility of improving staff engagement, and lessen EHR-induced clinician burnout. Our project implementation includes using informatics to achieve the desired state of a learning health system as recommended by the National Academy of Medicine as we facilitate feedback loops and rapid cycles of improvement.