Healthcare workers in the United States continue to experience high levels of job-related stress and burnout, particularly among nurses in the frontlines of healthcare delivery. Burnout is an occupational phenomenon that results from chronic workplace stress and is characterized by emotional exhaustion, negative feelings or mental distance from one’s job, and a low sense of accomplishment at work.
Nurses who work in the frontlines of healthcare delivery are often in high-stress environments and perform work that consists of complex tasks, heavy workloads and difficult schedules. These common challenges are factors that can lead to high levels of stress and burnout among nurses and can result in low job satisfaction, negative feelings towards one’s career, and intent to leave one’s job or profession.
During the last eight years, Debora Goetz Goldberg – who holds a PhD in health services, allied health and health sciences – has spent much of her time researching and writing about causes and solutions to address burnout experienced by physicians, nurses and other healthcare professionals.
She is an associate professor in the department of health administration and policy at the College of Public Health at George Mason University and affiliate faculty in the Center for Evidence-Based Behavioral Health in the Department of Psychology.
Her expertise is in the adoption and implementation of new technologies and innovative care delivery processes. During her career she has worked in various roles in the healthcare industry including frontline management at acute care hospitals, management consulting and as a university professor in health services research.
Healthcare IT News sat down with her to discuss how IT systems can improve coordination and communication for nurses, how IT for nurse work scheduling can provide flexibility for work schedules and improve workforce management, and how information technology can support workplace well-being.
Q. How can IT systems improve coordination and communication for nurses? And how can that help minimize burnout?
A. Advancements in IT systems have produced digital tools that can assist nurses with care coordination activities and communication between nurses and patients and between nurses and other healthcare workers. These technologies include telemedicine platforms, secure messaging tools, collaborative task management tools and virtual meeting applications.
There are many telemedicine platforms available that offer support for nurses to provide care to patients remotely, which can increase communication with hard-to-reach patients and provide flexibility in work arrangements. Secure messaging is another IT tool that can help nurses with communication.
An example of secure messaging is Paubox Email Suite, which is a HIPAA-compliant email system designed to securely communicate protected health information. Spruce Health and Zoom Healthcare are examples of systems that offer secure patient communication and virtual meetings that can be used to communicate with patients, families and care teams.
There also are collaborative task management tools, some of which are HIPPA-compliant, that can help nurses and nurse managers with creating task assignment and deadlines, project timelines or Gantt charts, file/document sharing, and real-time collaboration or chat. Some of these tools may offer integration with calendars, email or electronic health records.
These IT systems have the potential to increase efficiency of work performed by nurses and improve care provided to patients, therefore contributing to increased feelings of job satisfaction.
Successful adoption and implementation of new IT systems requires a clear understanding of nurses’ insights regarding useful features and how these systems can be seamlessly integrated into their routine practice.
In one qualitative study, nurses shared their perspectives on the benefits of incorporating innovative IT in the workplace. Nurses shared positive viewpoints on the benefits of IT systems that could provide tailored plans for patient care, improve communication, reduce workload and improve patient satisfaction.
For example, nurses saw the potential for artificial intelligence-enabled IT systems to be used for preliminary patient assessment and for using communication systems to share audio/visual data with patients to improve communication between patients and nurses. Nurses also reported concerns with implementation and use of IT, which include privacy issues, patient consent, required software updates and technical difficulties, adequacy of digital literacy by nurses and patients, and challenges with workload management.
This is similar to what nurses and other healthcare workers reported in my research at George Mason University, in addition to stressing the need for an IT system to have an easy-to-use interface and interoperability with other systems.
IT systems can assist frontline nurses by improving care coordination and enhancing communication, thus offering the potential to simplify job tasks and improve patient outcomes. The design and implementation of new systems should involve nurses and other healthcare workers whose work would be influenced by the new technology.
Implementation of new or modified IT systems should take into account workload requirements for nurses and required technical skills and training. Future research should evaluate the influence of new IT systems on nurse’s workload and their stress and well-being.
Q. You say IT for nurse work scheduling can provide flexibility for work schedules and improve workforce management. Please elaborate and talk about how this can help with the nurse burnout crisis.
A. Demanding work schedules and inability to take adequate breaks during shifts are contributing factors to burnout among nurses. In our research at George Mason University we found the number of hours worked per week is associated with burnout among nurses and other healthcare professionals. The association between the number of hours worked and burnout has been found in numerous studies, across healthcare professions.
There are many IT systems designed to support nurse scheduling that can help manage staffing, shifts, overtime and compliance in hospitals and outpatient settings. These systems could be used by nurse managers to set a maximum number of hours worked per day or week, schedule adequate time for breaks during shifts that allow for psychological detachment from work, and promote more flexibility and choice of work schedules for nurses.
Examples of healthcare scheduling systems include Kronos Workforce Scheduler, QGenda and ShiftWizard.
Q. Information technology can support workplace well-being. How can IT’s role in these areas help diminish burnout?
A. There is growing evidence that supports the use of specific IT tools focused on mindfulness and well-being to reduce stress and burnout among nurses and other healthcare professionals. For example, a randomized controlled trial of an AI‐assisted tailored burnout reduction program administered through the mobile application, Nurse Healing Space, found a significant reduction in nurse burnout scores compared with control groups.
In another randomized control trial conducted at the Mayo Clinic, researchers found significant improvement in stress and emotional well-being among participants using a smartphone-delivered resiliency-based intervention. At George Mason University we are currently conducting research that evaluates the effectiveness of StressPal Frontline, an online behavioral health application, in building psychological flexibility and reducing stress for nurses and other healthcare professionals.
Other researchers are evaluating the use of virtual reality technology to reduce stress and anxiety among healthcare workers. One example of the use of VR to support behavior health for frontline health workers is the Tranquil Cinematic-VR simulation of a tranquil nature setting, which resulted in significant reductions in stress among participants.
These IT tools can help address some of the work-related challenges that nurses and nurse leaders experience. However, a comprehensive solution is needed that addresses individual, organizational and system-level factors that contribute to burnout. We need organizational commitment and local/national policies that support the health, safety and well-being of nurses.
A comprehensive approach to address burnout would include leadership recognition and support, workplace safety measures that include activities to reduce workplace violence and harassment, participative leadership approaches that include nurses in decisions that influence their work, job redesign and/or changes to work schedules, and programs and services to support mental health and well-being.
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Healthcare IT News is a HIMSS Media publication.
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