Open AccessMultisite Quality Improvement Initiative to Repair Incomplete Electronic Medical Record Documentation As One of Many Causes of Provider Burnout
Author(s) -
Lauren Raney,
Joanne McManaman,
Mohamed Elsaid,
Jennifer Morgan,
Ronda Bowman,
Ashraf Mohamed,
Carolyn Russo
Publication year - 2020
Publication title -
jco oncology practice
Language(s) - English
Resource type - Journals
eISSN - 2688-1535
pISSN - 2688-1527
DOI - 10.1200/op.20.00294
Subject(s) - burnout , pdca , documentation , medicine , quality management , emotional exhaustion , thematic analysis , family medicine , nursing , medical emergency , qualitative research , operations management , management system , clinical psychology , social science , sociology , computer science , economics , programming language
PURPOSE: Provider burnout is a challenge adversely affecting the quality, safety, and cost of health care. We measured burnout among pediatric oncology providers in the St Jude Affiliate network and used a Plan-Do-Study-Act (PDSA) improvement cycle to address one of the factors contributing to burnout.METHODS: Within the framework of the ASCO Thematic Quality Training Program, we sent the Mini Z 2.0 Survey to 47 pediatric oncology providers. Applying a fishbone diagram and Pareto chart, we analyzed potential causes of provider burnout. On the basis of the analysis, we used a PDSA approach to address documentation of oral chemotherapy adherence for children with acute lymphoblastic leukemia to mitigate burnout among providers.RESULTS: The burnout survey response rate was 44.6%. Burnout was identified in 42.9% of providers. Documentation in the electronic medical record (EMR) was cited as the second most common contributor to burnout, and it was this issue we chose to address according to a priority matrix. We improved the completeness of oral chemotherapy documentation from a baseline of 13% compliance to 87% compliance within 3 months. The improved compliance was achieved by standardizing the documentation process in the EMR for content and location.CONCLUSION: The EMR was one of the contributing factors in the burnout survey of the pediatric oncology providers in the St Jude Affiliate network. A PDSA improvement model to improve clinical research documentation was successful in addressing one of several contributing factors to provider burnout.