Cargando…
Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review
BACKGROUND: OBJECTIVE: Electronic health records (EHRs) are linked with documentation burden resulting in clinician burnout. While clear classifications and validated measures of burnout exist, documentation burden remains ill-defined and inconsistently measured. We aim to conduct a scoping review...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068426/ https://www.ncbi.nlm.nih.gov/pubmed/33434273 http://dx.doi.org/10.1093/jamia/ocaa325 |
_version_ | 1783683030664085504 |
---|---|
author | Moy, Amanda J Schwartz, Jessica M Chen, RuiJun Sadri, Shirin Lucas, Eugene Cato, Kenrick D Rossetti, Sarah Collins |
author_facet | Moy, Amanda J Schwartz, Jessica M Chen, RuiJun Sadri, Shirin Lucas, Eugene Cato, Kenrick D Rossetti, Sarah Collins |
author_sort | Moy, Amanda J |
collection | PubMed |
description | BACKGROUND: OBJECTIVE: Electronic health records (EHRs) are linked with documentation burden resulting in clinician burnout. While clear classifications and validated measures of burnout exist, documentation burden remains ill-defined and inconsistently measured. We aim to conduct a scoping review focused on identifying approaches to documentation burden measurement and their characteristics. MATERIALS AND METHODS: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Extension for Scoping Reviews (ScR) guidelines, we conducted a scoping review assessing MEDLINE, Embase, Web of Science, and CINAHL from inception to April 2020 for studies investigating documentation burden among physicians and nurses in ambulatory or inpatient settings. Two reviewers evaluated each potentially relevant study for inclusion/exclusion criteria. RESULTS: Of the 3482 articles retrieved, 35 studies met inclusion criteria. We identified 15 measurement characteristics, including 7 effort constructs: EHR usage and workload, clinical documentation/review, EHR work after hours and remotely, administrative tasks, cognitively cumbersome work, fragmentation of workflow, and patient interaction. We uncovered 4 time constructs: average time, proportion of time, timeliness of completion, activity rate, and 11 units of analysis. Only 45.0% of studies assessed the impact of EHRs on clinicians and/or patients and 40.0% mentioned clinician burnout. DISCUSSION: Standard and validated measures of documentation burden are lacking. While time and effort were the core concepts measured, there appears to be no consensus on the best approach nor degree of rigor to study documentation burden. CONCLUSION: Further research is needed to reliably operationalize the concept of documentation burden, explore best practices for measurement, and standardize its use. |
format | Online Article Text |
id | pubmed-8068426 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-80684262021-04-28 Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review Moy, Amanda J Schwartz, Jessica M Chen, RuiJun Sadri, Shirin Lucas, Eugene Cato, Kenrick D Rossetti, Sarah Collins J Am Med Inform Assoc Reviews BACKGROUND: OBJECTIVE: Electronic health records (EHRs) are linked with documentation burden resulting in clinician burnout. While clear classifications and validated measures of burnout exist, documentation burden remains ill-defined and inconsistently measured. We aim to conduct a scoping review focused on identifying approaches to documentation burden measurement and their characteristics. MATERIALS AND METHODS: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Extension for Scoping Reviews (ScR) guidelines, we conducted a scoping review assessing MEDLINE, Embase, Web of Science, and CINAHL from inception to April 2020 for studies investigating documentation burden among physicians and nurses in ambulatory or inpatient settings. Two reviewers evaluated each potentially relevant study for inclusion/exclusion criteria. RESULTS: Of the 3482 articles retrieved, 35 studies met inclusion criteria. We identified 15 measurement characteristics, including 7 effort constructs: EHR usage and workload, clinical documentation/review, EHR work after hours and remotely, administrative tasks, cognitively cumbersome work, fragmentation of workflow, and patient interaction. We uncovered 4 time constructs: average time, proportion of time, timeliness of completion, activity rate, and 11 units of analysis. Only 45.0% of studies assessed the impact of EHRs on clinicians and/or patients and 40.0% mentioned clinician burnout. DISCUSSION: Standard and validated measures of documentation burden are lacking. While time and effort were the core concepts measured, there appears to be no consensus on the best approach nor degree of rigor to study documentation burden. CONCLUSION: Further research is needed to reliably operationalize the concept of documentation burden, explore best practices for measurement, and standardize its use. Oxford University Press 2021-01-12 /pmc/articles/PMC8068426/ /pubmed/33434273 http://dx.doi.org/10.1093/jamia/ocaa325 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Reviews Moy, Amanda J Schwartz, Jessica M Chen, RuiJun Sadri, Shirin Lucas, Eugene Cato, Kenrick D Rossetti, Sarah Collins Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review |
title | Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review |
title_full | Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review |
title_fullStr | Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review |
title_full_unstemmed | Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review |
title_short | Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review |
title_sort | measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review |
topic | Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068426/ https://www.ncbi.nlm.nih.gov/pubmed/33434273 http://dx.doi.org/10.1093/jamia/ocaa325 |
work_keys_str_mv | AT moyamandaj measurementofclinicaldocumentationburdenamongphysiciansandnursesusingelectronichealthrecordsascopingreview AT schwartzjessicam measurementofclinicaldocumentationburdenamongphysiciansandnursesusingelectronichealthrecordsascopingreview AT chenruijun measurementofclinicaldocumentationburdenamongphysiciansandnursesusingelectronichealthrecordsascopingreview AT sadrishirin measurementofclinicaldocumentationburdenamongphysiciansandnursesusingelectronichealthrecordsascopingreview AT lucaseugene measurementofclinicaldocumentationburdenamongphysiciansandnursesusingelectronichealthrecordsascopingreview AT catokenrickd measurementofclinicaldocumentationburdenamongphysiciansandnursesusingelectronichealthrecordsascopingreview AT rossettisarahcollins measurementofclinicaldocumentationburdenamongphysiciansandnursesusingelectronichealthrecordsascopingreview |