Improving Nursing EHR Satisfaction and Efficiency by Applying Lessons Learned from Physician Programs

Perspective from Jason Kulaga, Practice Director, Healthcare Solutions, Medix Technology

Programs designed to improve physician satisfaction and efficiency have been shown to increase overall job satisfaction, improve workflow efficiency and alleviate stressors contributing to burnout. A well-designed physician satisfaction and efficiency program is a wise investment that yields a significant ROI tied to patient throughput and reduced physician turnover. This is fantastic news, but it also begs the question: What about the other 80 percent of electronic health record users? Nursing EHR satisfaction is proving to be just as critical to program success as it is for their physician counterparts. 

Falling into the Physician Trap

As a nurse with a significant portion of my career focused on project management, implementation, and optimization of EHRs, I had somehow fallen into the trap of equating satisfaction and efficiency with physicians and focused the rest of my attention on system optimization and new feature implementation! While it’s true that the cost of replacing a physician is much higher than a nurse, there are four times as many registered nurses in the U.S. Nurses and other non-physician caregivers benefit just as much from efficiency gains and are at least as critical to the patient experience as physicians. 

As a vendor sponsor of the KLAS Research Arch Collaborative, I recently attended their annual Learning Summit. The number of organizations presenting on successful initiatives to measure and improve EMR satisfaction and efficiency was amazing. Bouncing between the provider and nursing tracks further reinforced both the similarities and shared benefits between the physician and nursing programs. I left the conference excited about the potential to further integrate surveying and benchmarking into initiatives to impact the user experience for all clinicians. 

Attending the conference exposed me to many organizations that are significantly impacting satisfaction and efficiency across all clinical disciplines. These organizations are substantially improving the EHR user experience while making training more efficient. In turn, this increases the time available for direct patient care by decreasing the time spent documenting in the system. How are they getting these amazing results? By applying the same basic principles inherent in a physician satisfaction and efficiency program to all disciplines. Obviously, the design and delivery need to be modified to reach a larger audience, but the core principles are the same. 

Five Key Components of Clinician EHR Satisfaction

Borrowing from Dr. Brian Patty’s eBook, The Blueprint for Building an Effective Physician EHR Satisfaction Program, there are five main components to a Physician Clinician EHR Satisfaction Program: Starting with a Strong Foundation, Training, Governance, Personalization, and Communication. 

  • Starting with a Strong Foundation: Ensure that your Epic system and associated technologies have been optimized to support clinician workflows. Honor Roll, Gold Stars, and keeping current with quarterly upgrades will ensure that you are providing the latest functionality to support users.
  • Training: Training is critical to end-user satisfaction and efficiency when using Epic. However, total time allocated to clinician onboarding and continuing training is not the key metric to focus on. Many organizations have achieved impressive results by applying adult learning principles and making their training more effective and efficient. Ideas include:
    • Retooling ongoing new user training to be workflow-based rather than reviewing features and functions.
    • Splitting new user training into a workflow introduction covering minimal requirements for their new role. Follow this training with an advanced class for remaining workflows that are scheduled after the new employee settles into their role.
    • Allocating time for informaticists to cover personalization during onboarding.
    • On-demand training and reference tools that are readily available to reinforce training. 
    • Creating informal education opportunities for peer-to-peer knowledge transfer.
  • Governance: A robust governance structure that includes operational representation at both the discipline and module levels will ensure that clinicians have input into the prioritization of enhancements and optimizations.
  • Personalization: Physician personalization is often focused at the individual level, which can seem overwhelming when expanding to include nursing, therapies, and other care team members. Consider an initial focus on nursing units and disciplines to develop a starter set of customization tools that can be incorporated into the onboarding process and informatics rounding. Even group personalization can have a significant impact on user efficiency.
  • Communication: Communication is a key component of clinician satisfaction programs. Oftentimes, organizations have configured and released functionality to better support clinician workflows only to bury the announcement in a 50-page upgrade summary that most clinicians will never take the time to read. Get creative! Lunch and learn sessions, informatics presentations at department meetings, tip sheets, drop-in labs, and other strategies are needed to provide timely, efficient, and consumable information to clinicians. It’s important to also consider the return pathway for communication. If the nurses in the NICU are using an “alternative” workflow for documentation, how does that get communicated to informatics for review and flagged for general adoption or workflow retraining? If a preceptor has a list of ten things that aren’t covered in training and need to be reviewed with new hires, how is that getting back to the curriculum designers? Do clinicians have a pathway for communicating annoyances that are easily fixed and not lost in a long list of ticket requests?   

The Benefits of Holistic Satisfaction

Transitioning from a physician-centric EHR satisfaction program to one focused on all clinicians provides an excellent opportunity to review existing governance, training, personalization, and communication programs within your organization and retool them to better meet the needs of your clinicians. The time, resources, and effort required may seem daunting, but the achievable indirect benefits and direct return on investment are significant justifications for investing in the satisfaction and efficiency of your clinicians. 

Interested in learning how Medix Technology can supply the leadership, guidance, and talent you need to accelerate the building of a successful and cost-effective clinician satisfaction program at your organization? Get in touch with our team today.

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