Optimization Sprints: Improving Clinician Satisfaction and Teamwork by Rapidly Reducing Electronic Health Record Burden

Abstract

Objective: To evaluate a novel clinic-focused Sprint process (an intensive team-based intervention) to optimize electronic health record (EHR) efficiency. Methods: An 11-member team including 1 project manager, 1 physician informaticist, 1 nurse informaticist, 4 EHR analysts, and 4 trainers worked in conjunction with clinic leaders to conduct onsite EHR and workflow optimization for 2 weeks. The Sprint intervention included clinician and staff EHR training, building specialty-specific EHR tools, and redesigning teamwork. We used Agile project management principles to prioritize and track optimization requests. We surveyed clinicians about EHR burden, satisfaction with EHR, teamwork, and burnout 60 days before and 2 weeks after Sprint. We describe the curriculum, pre-Sprint planning, survey instruments, daily schedule, and strategies for clinician engagement. Results: We report the results of Sprint in 6 clinics. With the use of the Net Promoter Score, clinician satisfaction with the EHR increased from À15 to þ12 (À100 [worst] to þ100 [best]). The Net Promoter Score for Sprint was þ52. Perceptions of "We provide excellent care with the EHR," "Our clinic's use of the EHR has improved," and "Time spent charting" all improved. We report clinician satisfaction with specific Sprint activities. The percentage of clinicians endorsing burnout was 39% (47/119) before and 34% (37/107) after the intervention. Response rates to the survey questions were 47% (97/205) to 61% (89/145). Conclusion: The EHR optimization Sprint is highly recommended by clinicians and improves teamwork and satisfaction with the EHR. Key members of the Sprint team as well as effective local clinic leaders are crucial to success.

Patient-reported outcomes following primary total hip arthroplasty in Crowe type Ⅲ or Ⅳ developmental dysplasia are comparable to those in Crowe type Ⅰ: a case-control study of 96 hips with intermediate-term follow-up

“…This fact could arti cially in ate the proportion of satis ed or unsatis ed patients. The response rates in this study were not high enough at 61% (23/38 cases); however, this proportion was similar to those reported in previous survey studies [Meyer R et al, 2018;Sieja A et al, 2019]. Third, the validity of the questionnaire used in this study had not been determined, and the presence of concurrent knee conditions at the time of the evaluation was overlooked.…”

Patient-reported outcomes following primary total hip arthroplasty in Crowe type Ⅲ or Ⅳ developmental dysplasia are comparable to those in Crowe type Ⅰ: a case-control study of 96 hips with intermediate-term follow-up

“…This fact could artificially inflate the proportion of satisfied or unsatisfied patients. The response rates of this study were not very high at 61% (23/38 cases), however those were almost the same as the previous survey studies [Meyer R et al, 2018;Sieja A et al, 2019]. Third, the validity evaluation of the questionnaire itself in this study had not been performed in the past, and the knee condition at the time of the evaluation had not been confirmed.…”

Transitions from One Electronic Health Record to Another: Challenges, Pitfalls, and Recommendations

“…These efforts may also help reduce revenue losses during implementations. 58 It is imperative to recognize and resolve hurdles prior to transition such as inadequate human infrastructure, technical challenges, unrealistic provider expectations, and insufficient training and support. Transitions are usually on a tight timeline.…”

“…A program that provides focused 1:1 optimization support and coaching for these individuals might prove transformative for clinicians' effective EHR use and for clinician wellness generally. 58…”