The Role of EHRs in Nurse Burnout

By

Mari Mineta Clapp

November 19, 2021

The Role of EHRs in Nurse Burnout

In September 2021, Providence St. Joseph Hospital in Eureka, California onboarded six much-needed traveling ICU nurses. Four quit the following day, citing challenges with the hospital’s new EHR as the primary reason.1

Nurses are a vital part of the healthcare system and are in high demand around the country. Studies2 have shown that healthcare facilities with an appropriate number of nurses have lower mortality rates and better patient outcomes. But America’s hospitals have been facing a nursing shortage since 2012, and experts3 estimate that up to 1 million to 1.2 million additional nurses will be needed by 2030. The United States Department of Health and Human Services4 predicts that California, Texas, and New Jersey will require the largest infusion in manpower.

The nursing shortage has large financial implications for hospitals and payers:

  • Statistics estimate that 1 in 5 nurses have quit during the COVID-19 pandemic.5 The National Healthcare Retention & RN Staffing Report6 estimates that it costs $37,700 to $58,400 to replace a single nurse. Hospitals across the country lose $5.2 million to $8.1 million annually replacing nursing staff. Increased nurse turnover during the COVID-19 pandemic cost as much as $88 billion to $137 billion7 as understaffed hospitals paid more to recruit and retain nurses. Larger hospitals felt this more acutely, particularly in the second and third quarters of 2020.
  • The COVID-19 pandemic contributed to high turnover rates as nurses quit their full-time jobs for contractual positions. Traveling nurses8 easily earn up to $5,000 per week, which is 5 times what they make when they are tied to a single employer. Understaffed hospitals are often forced to hire travel nurses9 to meet their manpower requirements, which increases hospital labor costs by up to 50%.
  • Studies10 have consistently shown that nursing shortages are associated with higher patient morbidity and mortality. Almost half of nurses in understaffed hospitals committed medication errors11 in the past year. On average, readmissions within 30 days of discharge cost Medicare an extra $15 billion12 annually. $3.8 billion13 in wrongful death lawsuits were paid out in 2017 alone.

Several factors contribute to this shortage, but nurse burnout is a significant and preventable concern. Nurse burnout is commonly attributed to long hours, high-stress environments, and lack of administrative support. Difficult EHR platforms are increasingly being cited as primary stressors. A survey14 of over 15,000 healthcare workers at 31 Michigan hospitals showed that 1/3 of all respondents were frustrated with healthcare technology. Nurses comprised the majority of respondents, followed by technicians and administrative support. The link between EHR usability and physician burnout15 has long been identified, but the drawbacks of poorly constructed EHRs clearly extend beyond the doctor into other clinical roles

A study16 by the University of Pennsylvania School of Nursing has shown that poor EHR usability is directly linked to poor nurse outcomes such as burnout, job dissatisfaction, and intention to leave, as well as poor patient outcomes such as mortality and readmission. “When the EHR system does not allow work to be performed efficiently and effectively, nurse burden increases, and patient outcomes are threatened,” says Ann Kutney-Lee, PhD, RN, FAAN, an adjunct associate professor at Penn Nursing. “ Improving EHR usability may be critical to reducing nurse burnout and to realizing the full potential of EHRs to improve the quality and safety of health care.”

Wellsheet offers a predictive workflow productivity platform that is integrated with major EHR providers and deployed quickly utilizing the Fast Healthcare Interoperability Resources (FHIR) application programming interface(API). Wellsheet customizes the physician’s view and presents the most important information first. “Wellsheet knows each patient’s problems and diagnoses,” says Stephen O’Mahony, MD, the Senior Vice President and Chief Health Information Officer at RWJBarnabas Health. Instead of “looking at a dozen screens to get all the information I need to make a decision, Wellsheet will give me all of the labs in a single graph.”

“Wellsheet predicts what that content will be in the most optimized format we believe that physician will want to see. But then we allow the end user to rearrange that content and add new pieces of data and make the view their own, which is something by and large that EHR systems cannot do, ”says Craig Limoli, the CEO and founder of Wellsheet.

While Wellsheet was first designed primarily for physicians, its features benefit all levels of the clinical care team. Having relevant, readily accessible data reduces the time needed to fulfill prescriptions, complete patient charts, and coordinate care. Wellsheet is also able to provide on-demand notifications and transfer of care handouts, which can reduce medication errors. “It highlights care gaps, opportunities, and how to best treat the patient in real time,” confirms O’Mahony. Moreover, the platform can be accessed with the same fidelity on any web browser or mobile device, so nurses who are always on-the-move between patients can remain updated and fully informed. Hospitals that use Wellsheet have reported an 89% reduction in caseload management time and 92% faster integration and deployment time.

Most importantly, Wellsheet recognizes that healthcare is a multidisciplinary effort. It encourages collaboration on its platform to allow care teams to provide more efficient and effective care. An overwhelming number of nurses cite: making a difference in people’s lives”17 as their top motivator for job satisfaction. Happy nurses deliver better patient care18 and are more likely to stay in their roles for longer, which reduces nursing turnover. Wellsheet helps make this happen.

Read about Wellsheet’s first payer partnership with Horizon Blue Cross Blue Shield of New Jersey, see Wellsheet in action or sign- up for a 1:1 demo.

Mari Mineta Clapp is VP of Marketing at Wellsheet and has worked with game changing technology companies in AI, Cloud, Collaboration and Networking. Her father was a general surgeon and pathologist and her mother was a registered nurse. Follow @Wellsheet_inc or @MariMinetaClapp

  1. https://www.beckershospitalreview.com/ehrs/travel-nurses-quit-california-hospital-after-1-day-over-ehr.html
  2. https://psnet.ahrq.gov/primer/nursing-and-patient-safety
  3. https://www.healthline.com/health/nursing-shortage#locations
  4. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nchwa-hrsa-nursing-report.pdf
  5. https://www.youtube.com/watch?v=sCBkbcffMAU
  6. https://avanthealthcare.com/pdf/NationalHealthcareRNRetentionReport2016.pdf
  7. https://www.feedtrail.com/general/nurse-burnout-in-the-wake-of-covid-19-can-cost-up-to-137b/
  8. https://apnews.com/article/business-health-coronavirus-pandemic-b6d58e41b209dd67ed0954f28b542baf
  9. https://www.fiercehealthcare.com/hospitals/hospital-executives-report-high-nursing-vacancies-greater-reliance-costly-travel-nurses
  10. https://www.aacnnursing.org/news-information/fact-sheets/nursing-shortage
  11. https://onlinedegrees.bradley.edu/blog/the-nursing-shortage-and-how-it-will-impact-patient-care/
  12. https://www.healthstream.com/resource/blog/the-economic-emotional-cost-of-hospital-readmissions&sa=D&source=docs&ust=1636726914974000&usg=AOvVaw0DWpFS-_svQBa--buSWQcD
  13. https://www.diederichhealthcare.com/the-standard/2017-medical-malpractice-payout-analysis/&sa=D&source=docs&ust=1636726959279000&usg=AOvVaw3DW6u_Fj_kseGlmHwu586P
  14. https://www.gsb.stanford.edu/insights/many-health-care-workers-are-emotionally-exhausted-technology-may-be-blame
  15. https://www.jmir.org/2020/12/e23382&sa=D&source=docs&ust=1636727035070000&usg=AOvVaw1HMKwoKVb3-8pSXTUDtyit
  16. https://pubmed.ncbi.nlm.nih.gov/33797506/&sa=D&source=docs&ust=1636727077095000&usg=AOvVaw2VIKQ96FHlLJYg_MhfM1Yf
  17. https://www.advisory.com/en/daily-briefing/2019/01/25/nurse-satisfaction
  18. https://journals.lww.com/ajnonline/Fulltext/2011/05000/Nurses__Job_Satisfaction_Linked_to_Patient.11.aspx