If you’ve noticed staff or providers showing any of the symptoms mentioned above, it might be time to evaluate one another and your practice.  Some factors that can contribute to these symptoms could be related to productivity expectations, patient complexity, documenting requirements, administrative tasks, late and on-call hours, negative leadership behaviors, advancement opportunities and salary limitations.  A person may also have personal characteristics that lead to burnout because they may be too self-critical, they are perfectionists, there could be a work-life imbalance, they may not have a support system outside of the office and may not have coping strategies to effectively deal with added stress.  

How can you collect the information to find out if staff is experiencing burnout?  

• Suggestion box 
• Staff and patient surveys 
• HR discussions 
• Open discussion in team meetings 
• Gossip chain 
• Anonymously 

How do you measure change after you have collected your data? 

Identify satisfaction, retention and burnout before you start to act.  Then, find the key indicators of the data you collected and what will be your next action steps for the solution. When you start to assess burnout, it is important to start the action right away to reduce burnout as soon as possible. Understanding the best method to collect this data for all your employees is also essential. Some employees will be open to communication, but others may not.    

Where to start eliminating burnout? 

Start with your Human Resources. Build activities to assess burnout into existing HR processes.  You can do this by integrating practices into your annual assessments, performance reviews (areas of strength and opportunities for improvement) and exit interviews. Continuous monitoring will help align with other HR Functions.  

Define the tools for this process that you are going to use. This could be starting a peer discussion group, surveys, focus groups, written assessments or suggestion boxes.   

Engagement with Senior Leadership can resolve issues rather quickly.  When you engage your leadership staff and or your board, you can reveal inside knowledge to guide you through new processes.  

General solutions for staff to reduce burnout and maintain staff retention.  

• Identify successful interventions other healthcare practices have implemented 
• Utilize team-based care model   
• Assign specific administrative time for clerical tasks  
• Offer flexible or part-time work schedules 
• Promote shared decision making  
• Train continuously   
• Embrace technology  
• Offer professional development opportunities  

Staff surveys like the Mini Z Assessment, the Maslach Burnout Inventory and the KLAS Arch Collaborative Survey can help measure and increase employee engagement, give employees a voice, direct organizational growth and benchmark results. 

What are some operational burdens identified for providers?  

• Knowledge constraints  
• EHR training (initial and ongoing) 
• Information overload 
• Alerts, summary screens, customization  
• Work environment  
• Work hours, schedules, panel size and acuity  
• Inefficiencies of the EHR  
• Use single sign on  
• Consider the setting for timing out or EHR and other systems 

Best practices to reduce provider burden  

There are many strategies to help reduce burden for providers. To help with overall efficiency and patient visits, we have noticed artificial intelligence has come into its own.  Natural Language Processing is the ability for computers to understand the latest human speech terms and text. It’s used in current technology to support spam email privacy, personal voice assistants and language translation applications. This helps computers understand and manipulate human language and can be very valuable for providers and staff.   

In order entry and standing orders, there is a huge overload of information for staff and providers.  It is crucial to understand what is important, what is critical to be known, what needs to be known at time of visit and what is important in visit and post visit. You can use this data during the time you have with the patient to overall have a better outcome.  

According to the American Medical Association, (AMA), “It is important to include other departments to support the initiative. By engaging common stakeholders, the initiative is set up for greater success, particularly if other departments can significantly improve their processes and work towards a common organizational goal. It is also recommended to include other departments at the beginning of your planning stages to prevent any potential barriers or delays to a solution. Please see the table below for common collaborations and how to get rid of the ‘Stupid Stuff’.” 

Health IT as part of a solution 

When we look at the culture of health IT, it is something that needs to have support from the executive level down. Starting at the top, your executives need to all be on the same page with the Electronic Health Record System that is currently in use. 

Interoperability in relation to healthcare is defined as the ability of computer systems or software to exchange and make use of information. The exchange of information between health systems is flowing faster than ever before, and new technology innovations are bringing more usable digital health information to providers and beyond.  

Not all healthcare providers can adapt at the same pace and there have been many hiccups in technology advances.  Workloads have changed from a pile of charts to an inbox or a PAQ.  Some of the same bad practices have been carried over from habits developed since the use of paper charts.  

The Office of the National Coordinator for Health Information Technology (ONC) has developed three Burden Reduction Goals that cover various ways to reduce provider burden:  

1. Reduce the effort and time required to record information in EHRs for health care providers during care delivery.
2. Reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals, and health care organizations.
3. Improve the functionality and intuitiveness (ease of use) of EHRs.

NextGen Configurations Opportunity:  

NextGen as a CERT Platform offers multiple configuration areas that promote efficiency and workflow. We usually hear from end-users that they lack the time or education to configure. Some areas are for practice implementation, while others may be specific for individual configurations.  Some of the configurations that end-users may not be familiar with are:    

• Order Sets 
• Standing Orders 
• Diagnosis based 
• Provider favorites 
• Lab vendors 
• Saved template sets – prepopulated templates 
• Individual portions: HPI, ROS, PE, etc.  
• Complete visit memorized set  
• Visit type configuration for workflows – framework navigation configured for practice 
• Medication favorites to streamline medication scribes 
• Diagnosis favorites 

Here are a few examples of the NextGen Configurations that can be customized for your practice to help assist with reducing burden.  

NextGen HIT Opportunities CHC’s can depend on to help reduce burden include: 

• NextGen Mobile  
• HQM - reporting tool  
• API Interfaces  
• Ryan White Reporting Console  
• EDI - patient appointment reminders 
• E-prescribing (ePS and ePCS)  
• NG Share- send CCDA for transitions of care 
• Patient Portal- patient access to health information, appointments, billing, etc. MedFusion for future
• Carequality- request and receive CCDA documents for patients 
• UDSX Console- reporting tool for Uniform Data Set for HRSA 
• Indian Health Services Reporting Tool 
• NextGen Population Health Analytics- reporting tool with ability to interface with labs, payers, etc.   
• Prescription Drug Monitoring Program (PDMP)  

These are examples of how NextGen meets ONC Requirements for their Certification.