Electronic Health Records Fatigue: A Different Kind of Burnout

Client

An EHR alert goes off for the hundredth time, and not one clinician bats an eye. Does this scenario sound familiar?

A different type of burnout has been hitting healthcare facilities across the US. It’s not new, but it’s not discussed enough. Electronic health records alert fatigue is a common struggle among many healthcare facilities. How can your health systems recognize this and begin to combat it?

The Problem

There’s a staggering number of medication-related decision-support alerts activated in the EHR to help protect patients – more than 1.4 million relate to drug-drug, drug-allergy, and drug-duplicate warnings alone. Many are unneeded, telling nurses and physicians what they already know. Even with the help of computerized physician order entry and clinical decision support, these alerts contribute to burnout, desensitization, and fatigue for those who use them.

Health care systems with high alert rates often also see high override rates, some up to 96%, and these facilities have a gleaming opportunity for EHR optimization and improvement. Yet, there are limitations and legal consequences to removing auditory or visual alerts to life-saving equipment. Active alerts cannot be just turned off or minimized.

Why It Matters

Electronic health record fatigue adds to the overwhelming amount of auditory and visual warnings that surround clinicians. Too many disruptive alerts lead to alert fatigue, decreasing their importance and desensitizing those who need to hear them. The brain’s primary defense mechanism against sensory overloads like this is to withdraw from it.

Sensory defensiveness increases the risk of impacting patient care. If it’s ignored, nurses can begin to experience increased:

  • desensitization
  • burnout
  • stress
  • safety errors
  • decision-regret
  • negativism or cynicism

Nurses are most at risk for work and lifestyle-related fatigue. Be aware of its causes, triggers, and resources available to combat it. The magnitude of both high and low-severity alerts encountered each day is preventable harm.

Strategy

Optimizing EHR alerts is an off-putting, resource-intensive, manual process that could take up too much valuable time and resources. What can you and your facility do to combat these EHR alerts and slow the spread of alert fatigue?

For Your Nurses:

  • Be aware and engaged on this issue. In these times, most employees, particularly contingent, don’t fear leaving as soon as their contract is complete. Acknowledging the fatigue your nurse’s experience could help with retention.
  • Focus on wellbeing and burnout prevention. If there’s not already a plan in place, launch a comprehensive strategy to address individual, organizational, leadership, and operational burnout. Implement a stress management program or introduce coping strategies to help offset the negative effects of alert fatigue.
  • Review the workflow of each clinical area and adjust alert preferences to make sure that the right information is displayed at the right time to the right user.

For Your EHR System:

  • Evaluate efficiency. Look at the appropriateness of alerts and fine-tune where necessary. This could mean changing severity levels, adjusting parameters, adding filters, and removing duplicates – whatever you can do to lessen the percentage.
  • Take a team approach. One person can’t tackle a project of this magnitude. Divide and conquer to address clinical area shortcomings and assess alerts as the system is updated and optimized.
  • Share your feedback with your EHR vendor. With this knowledge comes safer products, and a shared responsibility between vendors and hospitals.

These steps will improve alert significance and nurse productivity, while targeting the EHR fatigue impacting your health system. Steadfast hospitals have seen dramatic increases in both health record efficiency and provider satisfaction. Contact us to learn how we can help with your facility’s healthcare staffing needs to prevent burnout or help during EHR conversions.

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