. 2022 Aug 4;21(1):213.

doi: 10.1186/s12912-022-00989-w.

Identifying and adapting interventions to reduce documentation burden and improve nurses' efficiency in using electronic health record systems (The IDEA Study): protocol for a mixed methods study

Gillian Strudwick^{1

2

3}, Lianne Jeffs^{4

5

6}, Jessica Kemp⁷, Lydia Sequeira^{7

8}, Brian Lo^{4

7

9}, Nelson Shen^{4

7}, Petroiya Paterson¹⁰, Noelle Coombe⁹, Lily Yang¹¹, Kara Ronald¹², Wei Wang⁷, Sonia Pagliaroli¹³, Tania Tajirian^{9

14}, Sara Ling⁷, Damian Jankowicz⁹

Affiliations

¹ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Gillian.Strudwick@camh.ca.
² Centre for Complex Interventions, Centre for Addiction and Mental Health, 60 White Squirrel Way, Toronto, ON, M6J 1H4, Canada. Gillian.Strudwick@camh.ca.
³ Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada. Gillian.Strudwick@camh.ca.
⁴ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
⁵ Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.
⁶ Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
⁷ Centre for Complex Interventions, Centre for Addiction and Mental Health, 60 White Squirrel Way, Toronto, ON, M6J 1H4, Canada.
⁸ Canada Health Infoway, Toronto, ON, Canada.
⁹ Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada.
¹⁰ Clinical Informatics, Sinai Health, Toronto, ON, Canada.
¹¹ Quality and Patient Experience, Sinai Health, Toronto, ON, Canada.
¹² Professional Practice, Nursing and Health Disciplines, Sinai Health, Toronto, ON, Canada.
¹³ Cerner Canada, Markham, ON, Canada.
¹⁴ Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

PMID: 35927701
PMCID: PMC9351241
DOI: 10.1186/s12912-022-00989-w

Identifying and adapting interventions to reduce documentation burden and improve nurses' efficiency in using electronic health record systems (The IDEA Study): protocol for a mixed methods study

Gillian Strudwick et al. BMC Nurs. 2022.

. 2022 Aug 4;21(1):213.

doi: 10.1186/s12912-022-00989-w.

Authors

Affiliations

¹ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Gillian.Strudwick@camh.ca.
² Centre for Complex Interventions, Centre for Addiction and Mental Health, 60 White Squirrel Way, Toronto, ON, M6J 1H4, Canada. Gillian.Strudwick@camh.ca.
³ Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada. Gillian.Strudwick@camh.ca.
⁴ Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
⁵ Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.
⁶ Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
⁷ Centre for Complex Interventions, Centre for Addiction and Mental Health, 60 White Squirrel Way, Toronto, ON, M6J 1H4, Canada.
⁸ Canada Health Infoway, Toronto, ON, Canada.
⁹ Information Management Group, Centre for Addiction and Mental Health, Toronto, ON, Canada.
¹⁰ Clinical Informatics, Sinai Health, Toronto, ON, Canada.
¹¹ Quality and Patient Experience, Sinai Health, Toronto, ON, Canada.
¹² Professional Practice, Nursing and Health Disciplines, Sinai Health, Toronto, ON, Canada.
¹³ Cerner Canada, Markham, ON, Canada.
¹⁴ Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

PMID: 35927701
PMCID: PMC9351241
DOI: 10.1186/s12912-022-00989-w

Abstract

Background: Although EHR systems have become a critical part of clinical care, nurses are experiencing a growing burden due to documentation requirements, taking time away from other important clinical activities. There is a need to address the inefficiencies and challenges that nurses face when documenting in and using EHRs. The objective of this study is to engage nurses in generating ideas on how organizations can support and optimize nurses' experiences with their EHR systems, thereby improving efficiency and reducing EHR-related burden. This work will ensure the identified solutions are grounded in nurses' perspectives and experiences and will address their specific EHR-related needs.

Methods: This mixed methods study will consist of three phases. Phase 1 will evaluate the accuracy of the EHR system's analytics platform in capturing how nurses utilize the system in real-time for tasks such as documentation, chart review, and medication reconciliation. Phase 2 consists of a retrospective analysis of the nursing-specific analytics platform and focus groups with nurses to understand and contextualize their usage patterns. These focus groups will also be used to identify areas for improvement in the utilization of the EHR. Phase 3 will include focus groups with nurses to generate and adapt potential interventions to address the areas for improvement and assess the perceived relevance, feasibility, and impact of the potential interventions.

Discussion: This work will generate insights on addressing nurses' EHR-related burden and burnout. By understanding and contextualizing inefficiencies and current practices, opportunities to improve EHR systems for nursing professional practice will be identified. The study findings will inform the co-design and implementation of interventions that will support adoption and impact. Future work will include the evaluation of the developed interventions, and research on scaling and disseminating the interventions for use in different organizations, EHR systems, and jurisdictions in Canada.

Keywords: Burnout; Clinical informatics; Documentation; Efficiency; Electronic health records; Health information technology; Nursing; Nursing informatics.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
Overview of methods used in each phase of the mixed methods study

See this image and copyright information in PMC

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Identifying and adapting interventions to reduce documentation burden and improve nurses' efficiency in using electronic health record systems (The IDEA Study): protocol for a mixed methods study

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Identifying and adapting interventions to reduce documentation burden and improve nurses' efficiency in using electronic health record systems (The IDEA Study): protocol for a mixed methods study

Authors

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Abstract

Conflict of interest statement

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