Clinician burnout and time to care

Jan. 27, 2021 / By L. Gordon Moore, MD

When asked to reflect on what inspired their career choices most doctors and nurses will speak about the professional satisfaction and joy in helping people. They will talk about making a challenging diagnosis, helping a new mom master parenting skills, providing solace and comfort to a family grieving the loss of a loved one.

Ask them what they hate, and it often comes down to the administrative demands of dealing with the digital beast: The electronic health record, as well as growing documentation requirements. EHRs are a huge step forward and absolutely necessary. Still, because they were often not designed with the user experience in mind, they can be very frustrating to clinicians and be the cause of clinician burnout.   

Local configuration (“I want to document like this and not like that”) can cause others to spend precious time wading through a chart to glean important information. Behind-the-scenes data structures can frustrate search functions. Clinicians describe the “death-by-a-thousand-clicks” that takes up too much of their days. Even after going home from work, too many clinicians will log in to the EHR after putting kids to bed to finish up documentation from the day.

This does not have to be the lived experience of so many clinicians. Good user design engineering can help deliver just the right information at the right time in the documentation workflow with minimum effort from the user. Advances in data capture through speech natural language understanding makes it possible for clinicians to quickly speak their documentation and orders. Such technologies can not only transform the user experience but can also optimize the EHR itself.

We need to be mindful of doctors and nurses’ time to care—it is a precious resource. We must carefully consider what we ask of them in the documentation process, but at the same time help clinicians understand why it’s necessary to have certain data elements captured. If greater specificity leads to better patient care, then they will see it is as worthwhile. We also must be mindful of the technologies we ask them to use. Has the technology been designed with end user input? If not, it must be tested to understand how much friction and frustration we may be introducing. A “lower cost” solution that fails to consider user experience could create more burnout and more nurses and doctors ready to move to venues that value their time to care.

Clinician burnout was a big deal before COVID-19. It’s even bigger now.

L. Gordon Moore, MD, is senior medical director, Clinical Strategy and Value-based Care for 3M Health Information Systems.