Tech Worsened Nurse Burnout, Can a New Health IT Strategy Make it Right?

Nurses are unhappy, and they are letting hospital operators know it.

Nurse burnout, clinician shortages, compensation disputes, and the lingering effects of a global pandemic have made the nurse experience unbearable for many healthcare professionals. This recently came to a head in New York City, where 7,000 nurses walked out of two prominent hospitals for a three-day nursing strike. But the strike wasn’t an isolated phenomenon; six unions representing 32,000 nurses engaged in strikes outside of hospital systems across the country last year.

Hospital operators are retooling their nursing contracts to keep their staff happy and their patients healthy. Higher pay and better hours certainly help, especially in the post-pandemic environment, but leaders may need to look at their digital workflows to retain nurses and other clinicians over the long term.

“When you walk the floors to see what nurses have to do, the number of systems they have to touch just to check a patient out is cumbersome,” says Rahul Singh, senior partner at West Monroe, a national business and technology consulting firm. “In this situation, they are dealing with eight different screens where they have to enter data. It’s not very intuitive and not very efficient.”

Before the COVID-19 pandemic, technology was one of the main sources of clinician burnout. A 2019 American Medical Association (AMA) study attributed physician burnout to high volumes of data entry and poor EHR usability.

Many hospital systems don’t even have a single EHR system in which nursing workflows exist, according to Singh, who specializes in IT strategy and transformation and has worked as a top technology leader at several major insurance companies.

“Some nurse workflows require looking at multiple systems,” Singh states.

Going in and out of IT systems — or even the number of clicks in a single system — detracts from direct patient care. And this technology problem isn’t going away anytime soon. Healthcare is still in the early stages of its digital transformation, with more innovation to come. Hospital IT budgets seem to be safe from massive cuts seen elsewhere in the system.

One of the easiest ways to alleviate cost pressures because of the macro environment is to scale down labor. In healthcare, this can lead to significant savings; labor typically accounts for 50 to 60 percent of a hospital’s total budget.

However, the work doesn’t go away when hospitals reduce their workforce.

“Now, you just have fewer people trying to do the same amount of work,” Singh explains. “That’s going to be a challenge in today’s world. Given the financial challenges — and there aren’t any easy ways out here — hospitals need to focus more on the clinician experience and how to be more efficient.”

Technology has stepped up to automate more nursing workflows. For example, online diagnostics and symptom checks can help triage patients when nurses have many patients waiting. Voice recognition and automated data entry tools can also automate routine administrative tasks, so nurses have more time to spend in front of their patients. Hospital operators can even leverage workforce management solutions to optimize staff schedules.

Digital health tools can provide solutions in both senses of the word for hospitals struggling with nursing shortages and burnout. Singh suggests “leveraging technology to provide solutions that make their lives easier,” but hospital operators need to also take a broader look at nursing workflows, so these tools do not get in the way of a streamlined clinician experience.

“See how you can integrate things between systems to drive more efficiency so you can get more done without spending a lot of time,” he says.

Singh also sees an opportunity to leverage virtual nurses and similar solutions to alleviate the pressures on a hospital’s in-person workforce. Virtual clinicians can take some of the workflows bogging down in-house nurses, such as giving discharge instructions to patients leaving the hospital.

Some hospitals and health systems are also implementing software-based solutions that connect facilities with temporary talent when needed. This type of solution has been especially helpful for organizations facing severe staffing shortages, but all hospitals should consider incorporating contracted labor into their workforce management strategies, Singh says.

“We know the shortage is going to continue into the foreseeable future, so you have to shore up when you have these challenges,” he states.

Whether persistent clinician experience challenges will result in more strikes remains to be seen, but hospital operators need to be cognizant of how their nurses and other staff feel. Primary care providers, Singh provides as an example, have also been historically undervalued in the healthcare reimbursement system.

Strikes and shortages both increase costs for organizations, and healthcare, in particular, is tied to strict regulatory requirements surrounding the number of clinicians they must have on at a given time based on the facility’s bed count and operations. Meanwhile, reimbursement rates are not budging to account for higher wages, growing contract labor costs, and other rising expenses, Singh explains.

“I don’t see costs going down anytime soon given the shortage, so you have got to find ways to drive more efficiency and put in more tools to make nursing and other clinical workflows easier so they can do more with less,” he says.