scholarly journals A qualitative study of provider burnout: do medical scribes hinder or help?

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Sky Corby ◽  
Joan S Ash ◽  
Vishnu Mohan ◽  
James Becton ◽  
Nicholas Solberg ◽  
...  

Abstract Objective Provider burnout is a crisis in healthcare and leads to medical errors, a decrease in patient satisfaction, and provider turnover. Many feel that the increased use of electronic health records contributes to the rate of burnout. To avoid provider burnout, many organizations are hiring medical scribes. The goal of this study was to identify relevant elements of the provider–scribe relationship (like decreasing documentation burden, extending providers’ careers, and preventing retirement) and describe how and to what extent they may influence provider burnout. Materials and Methods Qualitative methods were used to gain a broad view of the complex landscape surrounding scribes. Data were collected in 3 phases between late 2017 and early 2019. Data from 5 site visits, interviews with medical students who had experience as scribes, and discussions at an expert conference were analyzed utilizing an inductive approach. Results A total of 184 transcripts were analyzed to identify patterns and themes related to provider burnout. Provider burnout leads to increased provider frustration and exhaustion. Providers reported that medical scribes improve provider job satisfaction and reduce burnout because they reduce the documentation burden. Medical scribes extend providers’ careers and may prevent early retirement. Unfortunately, medical scribes themselves may experience similar forms of burnout. Conclusion Our data from providers and managers suggest that medical scribes help to reduce provider burnout. However, scribes are not the only solution for reducing documentation burden and there may be potentially better options for preventing burnout. Interestingly, medical scribes sometimes suffer from burnout themselves, despite their temporary roles.

2018 ◽  
Vol 25 (2) ◽  
pp. 109-125 ◽  
Author(s):  
Mark Chun Moon ◽  
Rebecca Hills ◽  
George Demiris

BackgroundLittle is known about optimisation of electronic health records (EHRs) systems in the hospital setting while adoption of EHR systems continues in the United States.ObjectiveTo understand optimisation processes of EHR systems undertaken in leading healthcare organisations in the United States.MethodsInformed by a grounded theory approach, a qualitative study was undertaken that involved 11 in-depth interviews and a focus group with the EHR experts from the high performing healthcare organisations across the United States.ResultsThe study describes EHR optimisation processes characterised by prioritising exponentially increasing requests with predominant focus on improving efficiency of EHR, building optimisation teams or advisory groups and standardisation. The study discusses 16 types of optimisation that interdependently produced 16 results along with identifying 11 barriers and 20 facilitators to optimisation.ConclusionsThe study describes overall experiences of optimising EHRs in select high performing healthcare organisations in the US. The findings highlight the importance of optimising the EHR after, and even before, go-live and dedicating resources exclusively for optimisation.


Author(s):  
Ann L Bryan ◽  
John C Lammers

Abstract In this study we argue that professionalism imposed from above can result in a type of fission, leading to the ambiguous emergence of new occupations. Our case focuses on the US’ federally mandated use of electronic health records and the increased use of medical scribes. Data include observations of 571 patient encounters across 48 scribe shifts, and 12 interviews with medical scribes and physicians in the ophthalmology and digestive health departments of a community hospital. We found substantial differences in scribes’ roles based on the pre-existing routines within each department, and that scribes developed agency in the interface between the electronic health record and the physicians’ work. Our study contributes to work on occupations as negotiated orders by drawing attention to external influences, the importance of considering differences across professional task routines, and the personal interactions between professional and technical workers.


BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029314 ◽  
Author(s):  
Kaiwen Ni ◽  
Hongling Chu ◽  
Lin Zeng ◽  
Nan Li ◽  
Yiming Zhao

ObjectivesThere is an increasing trend in the use of electronic health records (EHRs) for clinical research. However, more knowledge is needed on how to assure and improve data quality. This study aimed to explore healthcare professionals’ experiences and perceptions of barriers and facilitators of data quality of EHR-based studies in the Chinese context.SettingFour tertiary hospitals in Beijing, China.ParticipantsNineteen healthcare professionals with experience in using EHR data for clinical research participated in the study.MethodsA qualitative study based on face-to-face semistructured interviews was conducted from March to July 2018. The interviews were audiorecorded and transcribed verbatim. Data analysis was performed using the inductive thematic analysis approach.ResultsThe main themes included factors related to healthcare systems, clinical documentation, EHR systems and researchers. The perceived barriers to data quality included heavy workload, staff rotations, lack of detailed information for specific research, variations in terminology, limited retrieval capabilities, large amounts of unstructured data, challenges with patient identification and matching, problems with data extraction and unfamiliar with data quality assessment. To improve data quality, suggestions from participants included: better staff training, providing monetary incentives, performing daily data verification, improving software functionality and coding structures as well as enhancing multidisciplinary cooperation.ConclusionsThese results provide a basis to begin to address current barriers and ultimately to improve validity and generalisability of research findings in China.


JAMA ◽  
2015 ◽  
Vol 314 (5) ◽  
pp. 519
Author(s):  
George A. Gellert ◽  
Ricardo Ramirez ◽  
S. Luke Webster

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e93047 ◽  
Author(s):  
Bernard Fernando ◽  
Zoe Morrison ◽  
Dipak Kalra ◽  
Kathrin Cresswell ◽  
Aziz Sheikh

2013 ◽  
Vol 88 (10) ◽  
pp. 1471-1477 ◽  
Author(s):  
Benjamin Jarvis ◽  
Tricia Johnson ◽  
Peter Butler ◽  
Kathryn O’Shaughnessy ◽  
Francis Fullam ◽  
...  

JAMA ◽  
2015 ◽  
Vol 314 (5) ◽  
pp. 518 ◽  
Author(s):  
Abdesalam Soudi ◽  
Anna-Binney McCague

2019 ◽  
Vol 11 (1) ◽  
pp. 4
Author(s):  
Estefanía Chamorro García ◽  
Inmaculada Hernández García ◽  
Ana Isabel Galve Marqués ◽  
Pilar Cabrerizo Torrente

El “handoff” o “pase del paciente” se define como el intercambio de información clínica cuando un nuevo médico o equipo médico asume el manejo de un paciente, bien sea de forma oral o escrita. La transmisión de información (handoff) oral, es una fuente de errores de comunicación y debe mejorar para disminuir los errores y los eventos adversos. La naturaleza estática de los documentos escritos hace que rápidamente la información se desactualice aumentando el error. Los documentos de handoff electrónicos, integrados en la historia clínica se han asociado con mejoras. La impresión hace que la actualización de los datos a tiempo real sea prácticamente imposible, incrementando el riesgo de una información inexacta. El objetivo del estudio fue determinar el tiempo en el que los datos clínicos del documento escrito se vuelven imprecisos, caracterizar el tipo de imprecisiones e identificar diferencias entre los turnos de día y de noche, así como entre servicios médicos y quirúrgicos. La hipótesis afirmaba que al final del turno de noche, la mayoría de los documentos de handoff contenían al menos un error, con potencial de producir daño. Se usó el término de “vida media”. Documentando estas imprecisiones, los autores esperaron que existiera la posibilidad de actualizar los datos en la historia clínica electrónica a tiempo real, con el objetivo de mejorar la seguridad del paciente. ABSTRACT  Expiry of a handoff printed document The handoff is defined as the change of clinical information about patients for whom physicians are responsible for between doctors and medical teams, both printed and verbal. Medical errors related to poor communication remain unacceptably common. Verbal handoffs are known to be high-risk source of communication errors and it may be improved to reduce adverse events. The static nature of printed documents makes it likely that some of the information will quickly become inaccurate, increasing the potential for medical errors. Computerised handoff documents integrated with electronic health records have been associated with improvements. Printing makes real-time automatic updating impossible, and therefore, increases the potential for inaccurate information. The main goals of this study were to measure the average time to potential inaccuracy of a printed handoff, to determine the types of inaccuracy and to identify differences between day and night shifts, as well as surgical and non-surgical services. They hypothesized that by the end of an overnight call shift, most handoffs documents would contain at least one error, which had the potential to impact patient care. They used the term  “half-life”. By documenting the inaccuracies which can be expected on printed handoff documents, the authors hope to achieve a shift toward reliance on the electronic health records on screen real, real-time, with the ultimate desired result of improved patient safety.


2021 ◽  
Author(s):  
Mollie Hobensack ◽  
Marietta Ojo ◽  
Kathryn Bowles ◽  
Margaret McDonald ◽  
Jiyoun Song ◽  
...  

Clinicians’ perspectives on the electronic health records (EHR) in home healthcare (HHC) are understudied. To explore this topic, qualitative interviews were conducted with 15 HHC clinicians in the Northeastern USA. Thematic analysis was conducted to identify key themes emerging from the interviews. While some EHR benefits were recognized, overall satisfaction with the EHR was low. The results suggest EHR limitations are tied to poor usability, restrictions, and redundancy in documentation leading to increased documentation workload. Clinicians have recommendations to mitigate these limitations via additional EHR functions and better patient risk detection. Future stakeholders should consider the results of this study when developing and updating the EHR in HHC.


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