Association of Electronic Health Record Design and Use Factors With Clinician Stress and Burnout

Autor: Sara Poplau, Mark Linzer, Fares Qeadan, Stewart F. Babbott, Nancy Morioka-Douglas, Kathryne Corrigan, Carolyn A. Parshall, Sharry Veres, Philip J Kroth
Rok vydání: 2019
Předmět:
Male
Cross-sectional study
health care facilities
manpower
and services
Burnout
Logistic regression
01 natural sciences
0302 clinical medicine
Risk Factors
Adaptation
Psychological
Ambulatory Care
Electronic Health Records
Stress measures
030212 general & internal medicine
Burnout
Professional
health care economics and organizations
Original Investigation
Workload
General Medicine
Focus Groups
Middle Aged
3. Good health
Online Only
Physician Assistants
Female
psychological phenomena and processes
Adult
medicine.medical_specialty
education
MEDLINE
Health Informatics
Subspecialty
Physicians
Primary Care
03 medical and health sciences
health services administration
medicine
Humans
Nurse Practitioners
0101 mathematics
Primary Health Care
business.industry
Research
010102 general mathematics
Health Surveys
Focus group
Cross-Sectional Studies
Logistic Models
Family medicine
Linear Models
business
Zdroj: JAMA Network Open
ISSN: 2574-3805
DOI: 10.1001/jamanetworkopen.2019.9609
Popis: Key Points Question Which electronic health record (EHR) design and use factors are associated with clinician stress and burnout? Findings In this survey study of 282 clinicians, clinician stress and burnout were associated with 7 EHR design and use factors. These 7 plus 2 other design and use factors collectively accounted for a modest amount of the variance in stress (12.5%) and burnout (6.8%); models incorporating other work conditions (such as chaotic work atmosphere and workload control) accounted for considerably more of the variance in stress (58.1%) and burnout (36.2%). Meaning While EHR design and use factors may appropriately be targeted by health systems and EHR designers to address stress and burnout, other non-EHR issues, especially clinician work conditions, appear to play a substantial role in adverse clinician outcomes.
This survey study determines which electronic health record (EHR) design and use factors are associated with clinician stress and burnout and identifies other sources that contribute to this problem.
Importance Many believe a major cause of the epidemic of clinician burnout is poorly designed electronic health records (EHRs). Objectives To determine which EHR design and use factors are associated with clinician stress and burnout and to identify other sources that contribute to this problem. Design, Setting, and Participants This survey study of 282 ambulatory primary care and subspecialty clinicians from 3 institutions measured stress and burnout, opinions on EHR design and use factors, and helpful coping strategies. Linear and logistic regressions were used to estimate associations of work conditions with stress on a continuous scale and burnout as a binary outcome from an ordered categorical scale. The survey was conducted between August 2016 and July 2017, with data analyzed from January 2019 to May 2019. Main Outcomes and Measures Clinician stress and burnout as measured with validated questions, the EHR design and use factors identified by clinicians as most associated with stress and burnout, and measures of clinician working conditions. Results Of 640 clinicians, 282 (44.1%) responded. Of these, 241 (85.5%) were physicians, 160 (56.7%) were women, and 193 (68.4%) worked in primary care. The most prevalent concerns about EHR design and use were excessive data entry requirements (245 [86.9%]), long cut-and-pasted notes (212 [75.2%]), inaccessibility of information from multiple institutions (206 [73.1%]), notes geared toward billing (206 [73.1%]), interference with work-life balance (178 [63.1%]), and problems with posture (144 [51.1%]) and pain (134 [47.5%]) attributed to the use of EHRs. Overall, EHR design and use factors accounted for 12.5% of variance in measures of stress and 6.8% of variance in measures of burnout. Work conditions, including EHR use and design factors, accounted for 58.1% of variance in stress; key work conditions were office atmospheres (β̂ = 1.26; P
Databáze: OpenAIRE
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