In an effort to enhance patient safety, streamline workflows and combat clinician burnout, Indiana's Community Health Network (CHN), a nine-hospital health system, they leveraged medication decision support technology to reduce nuisance alerts within their electronic medical record (EMR) system. Using a data-driven approach, CHN successfully reduced nuisance alerts by an impressive 77%.
For additional details, Health Exec spoke with Patrick McGill, MD, executive vice president and chief transformation officer at CHN, at the Healthcare Information Management Systems Society (HIMSS) 2023 meeting.
"Changing just six alerts in the system knocked out about 5 million alerts annually. So it was a huge win. Then we started to leverage more data, more analytics, really start to fine tune. Really it's about decision support, right? Alert, right time, right person. I think that's, a lot of times you see nuisance alerts when we're alerting the wrong person in the workflow. It's like, this doesn't even apply to me," McGill explained.
The nuisance alert challenge
Nuisance alerts in healthcare are notifications generated by EMR systems that are often irrelevant or non-actionable for clinicians. These alerts can overwhelm healthcare providers, leading to alert fatigue, decreased alert acceptance and potential patient safety risks. Alert fatigue is also a big contributor to clinician burnout, especially in nursing. Recognizing this issue, CHN set out to tackle the problem head-on.
CHN used data analytics from their Epic EMR system to identify the specific alerts that were causing the most frustration and disruptions in their workflows. By understanding the source of the problem, they could take targeted actions to address it.
"Several years ago we started hearing feedback from our clinicians, our doctors, our nurses saying, 'you're way over alerting us. What are you doing to us? Stop the nuisance alerts.' So we're really using data and analytics that we have in the system. We looked for the alerts that we can just take out that are total nuisance alerts that are not value added and are just driving people crazy," McGill said.
Partnering to help identify areas of improvement to reduce alerts
CHN did not face this challenge alone. They partnered with First Data Bank and Stanson, both experts in clinical decision support solutions. These partnerships allowed them to leverage cutting-edge technology and best practices in medication alerts and clinical decision support. Together, they aimed to make alerts more relevant, actionable, and patient-specific.
One of the key areas of focus was medication alerts. CHN and its partners worked diligently to fine-tune these alerts, ensuring they were accurate and contextually appropriate. By reducing unnecessary medication alerts, they significantly decreased the noise within the EMR system, leading to a more efficient and effective workflow for clinicians.
Alerts impact clinician burnout and staff turnover
Clinician burnout has been a growing concern in healthcare, exacerbated by the challenges posed by the COVID-19 pandemic. CHN recognized that reducing nuisance alerts could play a crucial role in addressing burnout. Their efforts not only improved alert acceptance by 200%, but he said they also helped mitigate the effects of staff turnover. New staff members, including traveling nurses, benefited from streamlined workflows guided by technology, making the onboarding process smoother and more efficient.
"Certainly addressing alerts helps burnout, but when you're seeing staff turnover, having the right workflow and to be able to guide new staff through the right workflow, especially if you're dealing with travelers or new nurses or new pharmacy staff, [really helps]. It's a symptom of burnout or a downstream effect of burnout when you have high turnover. ... As you're turning over your staff, you've got to be able to educate [replacement staff] quickly. If you can use your technology to drive staff to the right workflow, that's key," McGill explained.
McGill said using a data-driven approach, strategic partnerships and commitment to delivering the right alerts to the right people at the right time have yielded remarkable results. By prioritizing patient safety, clinician well-being and workflow efficiency, CHN has demonstrated that healthcare organizations can significantly enhance quality of care while simultaneously combating burnout and staff turnover.
McGill said alerts are often perceived as negative things and bombarding clinicians with alerts all day has a negative impact. This is especially true when the alerts do not even concern them.
"So instead of alerting them to say they've done the wrong thing, let's alert them to help them do the right thing. So it's the stick and the carrot, right? Let's give them more carrots and put the sticks away," McGill said.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com