3-Part 'Sprint' Intervention Eases Clinician EHR Burden

An 11-member intervention team redesigns workflows, develops new EHR tools, and trains clinicians to use the EHR more efficiently.

An intense, two-week program to improve electronic health record systems at the clinic level improves clinician satisfaction with the EHR significantly, recent research shows.

EHR burden has been cited as a primary contributor to clinician burnout. Research indicates that nearly half of physicians are experiencing burnout symptoms, and a study published in September found burnout increases the odds of physician involvement in patient safety incidents, unprofessionalism, and lower patient satisfaction.

In a study published this month in Mayo Clinic Proceedings, researchers show the two-week "Sprint" EHR intervention developed at Aurora, Colorado-based UCHealth increased clinician EHR satisfaction. On a net promoter scale ranging from -100 (worst) to +100 (best), clinician satisfaction with the EHR was -15 before the Sprint intervention and rose to +12 after the intervention.

The Sprint intervention is led by an 11-member team that helps clinic staff improve the EHR to make the system more efficient and user-friendly. The Sprint team includes one project manager, one physician informaticist, one nurse informaticist, four EHR analysts, and four EHR trainers.

Sprint intervention components
 

The Sprint intervention has three primary components: training clinicians to use the EHR more efficiently, redesigning a clinic's multidisciplinary workflow, and developing new specialty-specific EHR tools.

1. Training clinicians: In a Sprint intervention, clinicians participate in a two-hour kickoff meeting, three 1-to-1 training sessions, and a two-hour wrap-up session. In the 1-to-1 sessions, clinicians meet with either a trainer or the physician informaticist to learn specific skills or address frustrations with the EHR. The training content for Sprint features 10 sets of efficiency tips such as chart review efficiency, medical ordering efficiency, and medication management. 

2. Workflow redesign: To examine multidisciplinary workflow and patient flow, Sprint team members meet individually or in small groups with a clinic's non-clinician staff. After assessing strengths and weaknesses, trainers teach EHR best practices to the clinic staff, and the clinic manager redesigns common workflows to promote standardization. For example, a UCHealth clinic developed a pre-visit online patient questionnaire for neurological disorders that is used at every visit.

3. Specialty-specific EHR tools: Clinic leaders review all new EHR tool requests. Examples of popular new EHR tools are synopsis reports, flow sheets, patient-entered questionnaires, and customized note templates. New tools that receive approval are listed in a chart under five headings: backlog, to do, in process, done, and parking lot, with the last designation for tools that cannot be addressed during the Sprint intervention. The chart is available to the clinic staff and updated daily.

Sprint team strengths and ROI
 

Researchers found the Sprint intervention team model has several strengths:

• The physician informaticist plays a crucial role, translating clinician requests for EHR changes into technical solutions and training opportunities
   
• The nurse informaticist targets staff and team workflows
   
• The project manager gives the team a dedicated leader
   
• Having the Sprint team onsite boosts clinic staff engagement in the intervention and allows team members to confer easily and make decisions quickly

The researchers estimate that the Sprint intervention generates a significant positive return on investment.

For one Sprint team, the total annual cost of the invention program is about $1.7 million:

• The annual cost of funding one Sprint team, which can engage 500 clinicians, is estimated at $1.2 million.
   
• The annual cost of lost clinician productivity during Sprint interventions is about $500,000.

The researchers estimated that one Sprint team can reduce the number of annual burnout-related clinician departures by 2.5 staff members, which can generate annual cost avoidance as high as $2.5 million.