More and more nurses worry that the stress of their job is impacting their health, especially during a pandemic. This can lead to increasing rates of nurse burnout.
In fact, nurses experience many of the same stresses as physicians – increasing administrative burdens, demands to see more patients with less time, and the requirements of using EHR systems, which often are not built to adequately support clinical workflows.
Toni Laracuente, RN, chief nursing officer at EHR vendor Medicomp Systems, says that this year, the health IT industry needs to include the role of nurses in the conversations surrounding how to fix EHRs as one way of solving the EHR burnout issue. Just like physicians, the nursing profession is seeing a shortage, which will only increase as many look to retire.
AI ameliorating nurse burdens
There are various technologies that can help with the EHR burnout issue for nurses, Laracuente said. Artificial intelligence, for example, can ameliorate many administrative, burdensome tasks, she contended.
“AI and machine learning technologies offer great opportunities to lessen nurse burnout by reducing administrative burdens, especially the management tasks of hospital operations that require large amounts of data and fast, well-informed decisions,” she explained. “For example, predictive and prescriptive analytics can help nurse managers to predict and provide guidance on workloads, which can vary greatly by facility, department and specialty.”
"Using AI to automate administrative tasks also allows nurses, and nurse managers in particular, to focus more on strategic planning and proactive management, rather than constantly putting out fires and managing operations on an ad hoc basis"
Toni Laracuente, RN, Medicomp Systems
Based on predicted workloads, nurse managers can match staff scheduling, skill and facility resources, she added.
The ability to make automated workload predictions well in advance helps organizations to minimize barriers to patient care, improve patient flow and increase productivity across the organization – while also avoiding the unwanted surprises such as staff shortages and budget overruns that commonly occur when forecasts are based on intuition and static formulas, she said.
“Using AI to automate administrative tasks also allows nurses, and nurse managers in particular, to focus more on strategic planning and proactive management, rather than constantly putting out fires and managing operations on an ad hoc basis,” Laracuente said. “Nurses experience enormous frustration – and burnout – when they must repeatedly address the same operational problems without seeing resolution.”
Transforming manual tasks
High-quality, accessible data and AI can transform manual, time-consuming tasks such as repetitive documentation, bed management, workload management or resource scheduling, she added. This allows nurses to spend more time on activities relevant to their roles, practice at the top of their license and work on more complex challenges – the outcome is greater nurse satisfaction, lessening the risk of burnout and positively impacting safety and quality, she contended.
On another front, Laracuente said that fixing EHRs to reflect nurse workflows can shave minutes and hours from the time they need to spend on the EHR, and this can contribute to lessening nurse burnout.
“Many enterprise electronic health record systems were designed to facilitate billing, funding and compliance requirements,” she noted. “As a result, clinician workflows can be very siloed, not specific to a role or care setting and lacking in tools to facilitate efficient interdisciplinary communications. This puts the burden on nurses to find other ways to communicate critical patient information, which can be more time-consuming and less efficient.”
More specifically, improving usability of the EHR makes the nurse more productive in care delivery, she said. By creating and collecting clean, relevant data and presenting it in such a way that supports specific user workflow needs, health IT makers can eliminate information silos and build comprehensive clinical records that are truly patient-centric and support proactive, high-quality care, she added.
Making workflow tools intuitive
“Efficiencies also can be gained by making workflow tools intuitive for users and by supporting variation in needs across specialties, roles and departments,” she continued. “As clinical information systems have evolved, we have been presented with an opportunity to meet and support the requirements that are particular to specialized care environments such as ICU, ED or operating theatre.
“Often, specialist needs are met by highly specialized, purpose-designed clinical systems,” she added. “This is where interoperability challenges must be solved. If specialist care areas choose to use highly specialized tools, that option shouldn’t be at the expense of seamless workflow process and data exchange.”
Changes that optimize nursing workflows allow nurses to perform their jobs efficiently and effectively, Laracuente contended.
“When nurses must fight the EHR to do basic tasks, spending more time searching and documenting in the record, patient care and hospital throughput slows while frustration and burnout rates escalate,” she said.
“Using AI-powered solutions that streamline clinical workflows and bring the important clinical details to the forefront at the moment we need it, not only can we make faster, more informed decisions, but nurses, doctors and patient care staff have more time to interact with patients and perform clinical work, which ultimately improves staff and patient satisfaction.”
Additionally, addressing interoperability and usability issues is a significant factor in fixing EHRs for nurses, she said. Health IT vendors need to care for those delivering care by providing seamless, low-touch but high-quality systems that are user-friendly for people with a wide range of computing skills, also keeping in mind the aging nurse workforce, she said.
Nurse shortages around the globe
“In the United States and globally, we are experiencing significant nurse shortages, predicted to increase to around 1 million nurses by 2030, particularly in high-demand, high-stress environments such as ICU, obstetrics, ED and rural health regions,” she noted.
“There are many contributing factors; however, clinical systems that enhance, not hinder, our work are a major opportunity to improve productivity, lessen nurse burnout and retain new staff.”
Ultimately, Laracuente said that asking nurses what they need and creating EHRs that think and work like they do can be the difference in a successful or flawed EHR.
“Nurses (represent) the largest component of the healthcare workforce, yet for too long nurses were rarely asked to participate in EHR design and implementation projects,” she said.
“Thankfully, this has evolved in the last 10 years and now implementation teams usually realize the necessity of having nurses participate in the process. Understanding nurses’ unique needs across different specialties and roles helps drive adoption. End user engagement, consultation and ownership at every phase of clinical systems projects, from procurement to long-term post-go-live, is a critical success factor.”
It’s important to get nurse leadership involved in the process, but one also needs participation from the nurses who provide direct patient care, she insisted.
The clinical implementation team
“Members of the clinical implementation team should work closely with nurses as subject matter experts, educating and encouraging them to take advantage of new capabilities that come with clinical information systems, so they don’t simply automate what they had previously been doing manually,” she said.
Nurses are very focused on improving health outcomes and doing their jobs safely and effectively. They will embrace new technology if health IT vendors can show them how a well-designed EHR can improve outcomes, drive productivity and increase efficiencies, Laracuente said.
“The training process can’t be focused on checking boxes in the EHR, but instead must emphasize how the EHR allows nurses to use their knowledge and skills to improve care and their everyday work,” she concluded. “When designing and implementing an EHR, engaging nurses throughout the process can make the difference between the project’s success and failure.”