Accounting for taste: preferences mediate the relationship between documentation time and ambulatory physician burnout.

Autor:	Apathy NC; Health Policy & Management, University of Maryland School of Public Health, College Park, MD 20742, United States.; Regenstrief Institute, Indianapolis, IN 46202, United States., Hartman-Hall H; MedStar Health Center for Wellbeing, MedStar Health, Columbia, MD 21044, United States.; Clinical Medicine, Georgetown University School of Medicine, Washington, DC 20007, United States., Tran A; Institute for Quality and Safety, MedStar Health Research Institute, Columbia, MD 21044, United States.; Cecil B. Sheps Center for Health Services Research, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, United States., Kim DH; Health Management and Policy, Georgetown University School of Health, Washington, DC 20007, United States., Ratwani RM; National Center for Human Factors in Healthcare, MedStar Health Research Institute, Columbia, MD 21044, United States.; Emergency Medicine, Georgetown University School of Medicine, Washington, DC 20007, United States., Marchalik D; MedStar Health Center for Wellbeing, MedStar Health, Columbia, MD 21044, United States.; Urology, Georgetown University School of Medicine, Washington, DC 20007, United States.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Informatics Association : JAMIA [J Am Med Inform Assoc] 2024 Oct 01; Vol. 31 (10), pp. 2246-2254.
DOI:	10.1093/jamia/ocae193
Abstrakt:	Objectives: Physician burnout in the US has reached crisis levels, with one source identified as extensive after-hours documentation work in the electronic health record (EHR). Evidence has illustrated that physician preferences for after-hours work vary, such that after-hours work may not be universally burdensome. Our objectives were to analyze variation in preferences for after-hours documentation and assess if preferences mediate the relationship between after-hours documentation time and burnout. Materials and Methods: We combined EHR active use data capturing physicians' hourly documentation work with survey data capturing documentation preferences and burnout. Our sample included 318 ambulatory physicians at MedStar Health. We conducted a mediation analysis to estimate if and how preferences mediated the relationship between after-hours documentation time and burnout. Our primary outcome was physician-reported burnout. We measured preferences for after-hours documentation work via a novel survey instrument (Burden Scenarios Assessment). We measured after-hours documentation time in the EHR as the total active time respondents spent documenting between 7 pm and 3 am. Results: Physician preferences varied, with completing clinical documentation after clinic hours while at home the scenario rated most burdensome (52.8% of physicians), followed by dealing with prior authorization (49.5% of physicians). In mediation analyses, preferences partially mediated the relationship between after-hours documentation time and burnout. Discussion: Physician preferences regarding EHR-based work play an important role in the relationship between after-hours documentation time and burnout. Conclusion: Studies of EHR work and burnout should incorporate preferences, and operational leaders should assess preferences to better target interventions aimed at EHR-based contributors to burnout. (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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