Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
BMJ Open. 2022 Aug 19;12(8):e060865. doi: 10.1136/bmjopen-2022-060865.
Healthcare provider (HCP) burnout is on the rise with electronic medical record (EMR) use being cited as a factor, particularly with the rise of the COVID-19 pandemic. Burnout in HCPs is associated with negative patient outcomes, and, therefore, it is crucial to understand and address each factor that affects HCP burnout. This study aims to (a) assess the relationship between EMR use and burnout and (b) explore interventions to reduce EMR-related burnout.
We searched MEDLINE (Ovid), CINAHL and SCOPUS on 29 July 2021. We selected all studies in English from any publication year and country that discussed burnout in HCPs (physicians, nurse practitioners and registered nurses) related to EMR use. Studies must have reported a quantitative relationship to be included. Studies that implemented an intervention to address this burnout were also included. All titles and abstracts were screened by two reviewers, and all full-text articles were reviewed by two reviewers. Any conflicts were addressed with a third reviewer and resolved through discussion. Quality of evidence of all included articles was assessed using the Quality Rating Scheme for Studies and Other Evidence.
The search identified 563 citations with 416 citations remaining after duplicate removal. A review of abstracts led to 59 studies available for full-text assessment, resulting in 25 studies included in the scoping review. Commonly identified associations between EMR-related burnout in HCPs included: message and alert load, time spent on EMRs, organisational support, EMR functionality and usability and general use of EMRs. Two articles employed team-based interventions to improve burnout symptoms without significant improvement in burnout scores.
Current literature supports an association between EMR use and provider burnout. Very limited evidence exists for burnout-reducing interventions that address factors such as time spent on EMRs, organisational support or EMR design.
随着电子病历(EMR)的使用被认为是一个因素,医疗保健提供者(HCP)的倦怠现象正在上升,尤其是在 COVID-19 大流行期间。HCP 的倦怠与负面的患者结果有关,因此,了解和解决影响 HCP 倦怠的每个因素至关重要。本研究旨在:(a)评估 EMR 使用与倦怠之间的关系;(b)探索减少与 EMR 相关的倦怠的干预措施。
我们于 2021 年 7 月 29 日在 MEDLINE(Ovid)、CINAHL 和 SCOPUS 上进行了搜索。我们选择了所有来自任何出版年份和国家的英语研究,这些研究讨论了与 EMR 使用相关的 HCP(医生、执业护士和注册护士)的倦怠。必须报告了与该倦怠相关的定量关系的研究才被包括在内。还包括实施干预措施以解决这种倦怠的研究。两位评审员筛选了所有标题和摘要,两位评审员审查了所有全文文章。任何冲突都由第三位评审员解决,并通过讨论解决。所有纳入文章的证据质量均使用研究和其他证据质量评分方案进行评估。
搜索确定了 563 条引文,去除重复项后剩余 416 条引文。对摘要的审查导致有 59 篇研究可供全文评估,其中 25 篇研究被纳入范围综述。在 HCP 中,与 EMR 相关的倦怠之间通常存在关联,包括:消息和警报负载、在 EMR 上花费的时间、组织支持、EMR 功能和可用性以及 EMR 的一般使用。有两篇文章采用了基于团队的干预措施来改善倦怠症状,但对倦怠评分的改善没有显著作用。
现有文献支持 EMR 使用与提供者倦怠之间的关联。关于减少与 EMR 使用时间、组织支持或 EMR 设计等因素相关的倦怠的干预措施的证据非常有限。