Kannampallil Thomas, Abraham Joanna, Lou Sunny S, Payne Philip R O
Institute for Informatics, Washington University School of Medicine, St Louis, Missouri, USA.
Department of Anesthesiology, Washington University School of Medicine, St Louis, Missouri, USA.
J Am Med Inform Assoc. 2021 Apr 23;28(5):1032-1037. doi: 10.1093/jamia/ocaa305.
Electronic health records (EHR) use is often considered a significant contributor to clinician burnout. Informatics researchers often measure clinical workload using EHR-derived audit logs and use it for quantifying the contribution of EHR use to clinician burnout. However, translating clinician workload measured using EHR-based audit logs into a meaningful burnout metric requires an alignment with the conceptual and theoretical principles of burnout. In this perspective, we describe a systems-oriented conceptual framework to achieve such an alignment and describe the pragmatic realization of this conceptual framework using 3 key dimensions: standardizing the measurement of EHR-based clinical work activities, implementing complementary measurements, and using appropriate instruments to assess burnout and its downstream outcomes. We discuss how careful considerations of such dimensions can help in augmenting EHR-based audit logs to measure factors that contribute to burnout and for meaningfully assessing downstream patient safety outcomes.
电子健康记录（EHR）的使用通常被认为是导致临床医生职业倦怠的一个重要因素。信息学研究人员经常使用源自EHR的审计日志来衡量临床工作量，并将其用于量化EHR的使用对临床医生职业倦怠的影响。然而，将基于EHR的审计日志所衡量的临床医生工作量转化为有意义的职业倦怠指标，需要与职业倦怠的概念和理论原则保持一致。从这个角度来看，我们描述了一个面向系统的概念框架来实现这种一致性，并使用三个关键维度描述了这个概念框架的实际应用：规范基于EHR的临床工作活动的测量、实施补充测量，以及使用适当的工具来评估职业倦怠及其下游结果。我们讨论了对这些维度的仔细考量如何有助于扩充基于EHR的审计日志，以衡量导致职业倦怠的因素，并对下游患者安全结果进行有意义的评估。
