In a different blog post, we addressed how alert fatigue impacts patient care and what you can do about it. Now, let’s take a look at healthcare efficiency from a provider perspective - namely, how to avoid alert fatigue and burnout, while still encouraging high quality care delivery, with the help of healthcare technology.
There’s a wide array of healthcare technology in use today, all designed to provide better patient care, increase patients’ access to their health information, improve healthcare safety and outcomes, and/or increase productivity for providers and entire health systems.
Most healthcare organizations have developed robust clinical decision support systems (CDSS), which are designed to improve clinical decision making at the point of care. These decisions may relate to either diagnostic actions (e.g., lab tests) or therapeutic processes (e.g., recommended next steps for a sepsis patient). They can also help drive better documentation, more accurate billing activities, and many other operational tasks.
A CDSS also can be used to analyze data from a patient’s electronic health record (EHR) in order to deliver patient-specific alerts about possible drug interactions and known medication allergies, recommended lab orders and suggested screenings, additional procedures that should be considered, and other activities based on the contents of the health record. These alerts can help providers avoid costly mistakes and help provide life-saving tips when time is of the essence.
The downside of EHR alerts
Not all clinicians agree EHR alerts increase productivity and efficiency. They’re often overwhelmed by the sheer number of alerts, many of which do not provide clinically significant information. This 2019 study showed three main findings in regards to EHR alerts:
- They may be ineffective if they are inappropriately deployed
- Alert fatigue is common; clinicians override the “vast majority” of EHR alerts
- As EHR alert volume increases, so does alert fatigue - and that’s just one of many factors causing clinician burnout.
In fact, we’re in the midst of an epidemic of burnout among healthcare professionals, and it’s no wonder why. The COVID-19 pandemic has only compounded the issues clinicians were already facing, adding mental health challenges to a growing list of burnout factors, including:
- Frustration with EHR system design, cost, and maintenance
- Less time for 1-on-1 patient interaction
- Longer workdays
- Demands of meeting clinical quality measures (CQMs)
Even worse, alert fatigue doesn’t just affect clinicians. The downstream effects are vast, impacting numerous stakeholders within each health system, including anyone who participates in clinical workflows like medical assistants, unit secretaries, and more. This systemic numbness to alerting means that the next important alert that the user actually needs to pay attention to may go unheeded when their mental model for alerts summarizes simply: “this is noise.”
Beyond those participating in clinical care workflows, the impact of alert fatigue can extend beyond the walls of the care setting. Take, for example, the health IT developers who designed a CDSS that makes EHR alerting possible, the quality improvement (QI) teams that undertake initiatives to improve patient care, and the health system C-suite, which invested millions of dollars, plus time, and additional resources into a system that may not be meeting their needs. A less efficient healthcare system increases costs across every department and aspect of the healthcare system, ultimately impacting the patient experience and cost of care.
How to avoid alert fatigue and burnout with healthcare technology
These studies may paint a grim picture around alert fatigue and clinician burnout, but there’s reason to be optimistic. Healthcare technology, including informatics platforms such as Phrase Health’s Interventions and Outcomes products, offer health systems tools to assess their current alerting and suggest changes to improve efficiency and patient outcomes.
With the use of clinical informatics principles and advanced data analysis, here are some recommended steps you can take right now:
- Review your organization’s goals and initiatives.
- Is your goal to improve efficiency? Reduce alert overrides? Improve patient outcomes? Whatever your goals, ensure the systems and protocols - including EHR alerts - you put in place align with your overall organizational priorities.
- An informatics provider can help you assess your CDSS and EHR alerting systems as your organization’s needs and goals evolve over time.
- Review alert data and insights. Keeping your goals in mind, an informatics platform should provide key data to help inform decision making, such as:
- Make a plan for consolidating and/or prioritizing alerts, ensuring the right alerts get to the right clinical staff in the right format and channel at precisely the right time in the workflow.
- If your primary goal is to reduce alert fatigue and burnout, the data and insights you’ve gathered from your informatics platform can help you make the best decisions to optimize alerts and increase efficiency.
- Establish a content management strategy, ensuring that alerts are being regularly reviewed and vetted by local subject matter experts. This way, as medical research evolves and employees come and go, information being delivered to your organization will always be up-to-date and relevant.
