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BACKGROUND: As the field of palliative care continues to grow, many clinicians will care for patients with whom they have personal connections. Breaching the boundary between a clinician's personal and professional life is potentially an unrecognized risk for burnout. OBJECTIVE: We explored the challenges of caring for patients personally known to clinicians and the types of support needed, with a view to developing preliminary practice guidelines. DESIGN: Focus groups. Setting/Subjects: Thirteen psychosocial oncology and palliative care clinicians who care for adult patients participated in one of two focus groups. Six participants were physicians, four were nurse practitioner/registered nurse/physician assistant (NP/RN/PAs), and three were psychosocial clinicians. MEASUREMENT: Using NVivo 12, we analyzed focus group transcripts from clinicians about their experiences caring for patients they know personally, the impact of such experiences, and the type of support and guidelines that could benefit clinicians in these unique situations. RESULTS: Navigating boundaries and managing the psychological impact on the clinician, including fear of negative evaluation, increased anxiety and emotional exhaustion were the most challenging aspects of providing such care. Suggested guidelines include an early team meeting, a buddy system, a conversation guide to address the dual relationship, and embedded psychological support and mentorship. CONCLUSIONS: Feedback from clinicians identified preliminary guidelines that incorporate tools palliative care teams can use to improve support for clinicians caring for patients with whom they have a personal connection. These tools address the psychosocial aspects of care and have the potential to help clinicians feel a greater sense of control in these often, challenging and emotionally taxing situations.

According to the Bureau of Labor Statistics (BLS), as of June 2022, hospitals are down 65,000 employees from February 2020. NAVIGATING THE CHALLENGES To address the magnitude of this problem, the AHA Board of Trustees' Task Force on Workforce and the International Association for Healthcare Security & Safety developed a report titled Creating Safer Workplaces: A Guide to Mitigating Violence in Health Care Settings (www.aha.org/workplace-violence). Aspen Valley Hospital in Colorado provides quiet rooms for staff to use for “time outs” from stressful situations; Hackensack Meridian Health in New Jersey offers educational classes and training on stress management; Cody Regional Health in Wyoming has on-site access to licensed therapists for emotional support; and in Delaware, ChristianaCare's new Center for WorkLife Wellbeing, physicians can share and process traumatic experiences. To this end, we are partnering with a coalition of stakeholders on a workforce agenda focusing on: lifting the cap on Medicare-funded physician residencies, boosting support for nursing schools and faculty, providing scholarships and loan repayment for certain providers, and expediting visas for all foreign highly trained healthcare personnel; supporting efforts to bolster nursing faculty to ensure that hospitals have the nurses they need in the future (schools turned away more than 90,000 qualified applicants from baccalaureate and graduate programs in 2021 alone due to an insufficient number of faculty, clinical sites, and classrooms according to the American Association of Colleges of Nursing, 2022); establishing a Rural America Health Corps modeled on the National Health Service Corps to encourage healthcare professionals to serve in rural areas; extending and expanding the Conrad State 30 J-1 visa waiver program, which waives the requirement to return home for a period if physicians holding J-1 visas agree to stay in the United States for 3 years to practice in a federally designated underserved area; encouraging Congress to support bipartisan legislation, such as the SAVE Act, to protect healthcare workers against workplace violence; increasing regulatory oversight of nurse staffing agencies to deal with price gouging and anticompetitive behavior that exploits the pandemic by charging hospitals exorbitant prices for contract workers (legislation pending on Capitol Hill would require an independent review of these practices); supporting states' efforts to expand the scope of practice laws allowing healthcare professionals to practice at the top of their licenses; and stopping health insurers' burdensome practices that take caregivers away from the bedside and increase burnout and turnover. [...]the AHA was proud to support and obtain funding for the new Dr. Lorna Breen Health

Occupational health and safety programmes aim to prevent diseases and injuries arising out of, linked with or occurring in the course of work, while improving the quality and safety of care, safeguarding the health workforce and promoting environmental sustainability in the health sector.

This guide provides an overview of the key elements of occupational health and safety programmes for health workers at national, subnational and facility levels, as well as advice for the development and implementation of such programmes.

This resource is found in our Actionable Strategies for Health Organizations: Ensuring Physical & Mental Health (Occupational Safety) AND Ensuring Workers' Physical and Mental Health (Strengthen Occupational Safety and Health Policies).

Suicide is the most common cause of death in male resident physicians and the second most common cause of death in resident physicians overall. Physicians also experience high rates of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and burnout. These conditions frequently develop during medical school, and threaten not only physicians but the patients they care for. A 30-year-old medical student presented to our clinic with a history of treatment-resistant depression (TRD), generalized anxiety disorder (GAD), PTSD, and 5 years of daily suicidal ideation. Previous treatments included therapy, lifestyle modifications, and various combinations of six antidepressants. These interventions had little effect on the patient's mental health. The patient was treated at our clinic with an 8-month regimen of IV ketamine infusions and ketamine-assisted psychotherapy (KAP). The patient achieved remission from suicidality and PTSD within 1 month; and TRD and GAD within 7 months. The patient's Patient Health Questionnaire (PHQ-9) score decreased from 25 (severe depression) to 1 (not depressed). These findings suggest that ketamine and KAP may represent effective interventions for mental health applications in healthcare professionals. The patient made the unique decision to attempt to type narrative journals during four of his ketamine infusions (doses ranged from 1.8 to 2.1 mg/kg/h IV). The patient successfully typed detailed journals throughout each 1-h ketamine infusion. To our knowledge, these journals represent the first independently typed, first-person, real-time narratives of ketamine-induced non ordinary states of consciousness. The transcripts of these journals may provide useful insights for clinicians, particularly in the context of KAP.

Diversity, equity, and inclusion (DEI) is a framework used to promote high performance teams, prioritizing principles of justice and intersectionality. There is abundant evidence that members of marginalized communities, such as racial and ethnic minorities and sexual and gender minorities, experience higher threats to well-being than members of dominant groups. Such threats include systemic racism and discrimination, bias, sexism, and homophobia, all of which are deeply ingrained in medical culture. Recognizing and responding to these threats requires an understanding of how individual identities influence interactions in the workplace, including evaluations and promotions, team dynamics, and career trajectory. Discrimination and bias are known contributors to adverse outcomes in emotional and physical health, career satisfaction, and social connectedness in the workplace. Any effort to promote well-being and decrease burnout must center DEI as a foundational component of that effort, or risk further marginalization of certain groups and likely failure of the intervention.

OBJECTIVE: To evaluate the prevalence of burnout and satisfaction with work-life integration (WLI) in US physicians at the end of 2021, roughly 21 months into the COVID-19 pandemic, with comparison to 2020, 2017, 2014, and 2011. METHODS: Between December 9, 2021, and January 24, 2022, we surveyed US physicians using methods similar to our prior studies. Burnout, WLI, depression, and professional fulfillment were assessed using standard instruments. RESULTS: There were 2440 physicians who participated in the 2021 survey. Mean emotional exhaustion and depersonalization scores were higher in 2021 than observed in 2020, 2017, 2014 and 2011 (all Journal Pre-proof p<.001). Mean emotional exhaustion scores increased 38.6% (2020 mean=21.0; 2021 mean=29.1; p<.001) while mean depersonalization scores increased 60.7% (2020 mean=6.1; 2021 mean=9.8; p<.001). Overall, 62.8% of physicians had at least one manifestation of burnout in 2021 compared with 38.2% in 2020, 43.9% in 2017, 54.4% in 2014, and 45.5% in 2011 (all P<.001). While these trends were consistent across nearly all specialties, substantial variability by specialty was observed. Satisfaction with WLI declined from 46.1% in 2020 to 30.2% in 2021 (P<.001). Mean scores for depression increased 6.1% (2020 mean=49.54; 2021 mean=52.59; p<.001). CONCLUSION: A dramatic increase in burnout and decrease in satisfaction with WLI occurred in US physicians between 2020 and 2021. Differences in mean depression scores were modest suggesting the increase in physician distress was overwhelmingly work-related. Given the association of physician burnout with quality of care, turnover, and reductions in work effort, these findings have profound implications for the US healthcare system.

[This is an excerpt.] Even during what may be considered “normal” times, the work of public safety employees (e.g., police, firefighters, emergency medical service [EMS] personnel, and 9-11 dispatchers) can be categorized as high risk and high stress. When human error is introduced, the services provided by public safety professionals have the potential to result in extremely harmful and fatal outcomes. First responders, or the individuals responsible for immediately going to the scene of an emergency to assist, are often exposed to dangerous situations and required to make rapid, critical decisions. This duty does not rest on a few individuals; it is believed that over three million individuals in the United States alone may be considered first responders, and their employing departments have annual operating budgets of over $181 billion (Department of Homeland Security, 2017). [To read more, click View Resource.]

STUDY OBJECTIVES: Management research suggests that effective communication by leaders is associated with reduced burnout and improved coordination. However, characteristics of communication that make it more useful to those who receive it are not well understood. The study objective was to examine associations between how emergency department (ED) staff experienced information communicated by leaders during the COVID-19 pandemic and their experience of burnout and teamwork. METHODS: A cross-sectional survey was administered to 635 ED staff (N = 191, response rate = 30%) working in 2 EDs affiliated with an academic emergency medicine program in California between October-December 2021. Burnout (“based on your definition of burnout, how would you rate your level of burnout?”) was measured on a 5-point Likert scale. Teamwork experience was measured as the mean of 2 modified items from a validated scale asking, “during a clinical shift, when problems arose due to COVID, we addressed them as a team effort in the ED” and “we have been able to rely on all roles to jointly solve problems due to COVID in this ED.” Informed by qualitative interviews reported in a previous study and measures from previously developed instruments, questions regarding the characteristics of information communication by leaders were developed. Exploratory factor analysis (EFA) was conducted using principle axis factoring with oblique rotation. Factor extraction criteria included eigen values exceeding the threshold of 1. Items were assigned to factors if they had loadings >0.4. These factors were assessed in relation to experienced burnout and teamwork using linear regression models (Table 1). Models controlled for age, sex, race, role, and primary shift worked. RESULTS: EFA results suggested a 3-factor solution. Factors consisted of items related to information flow (ie “information is shared too frequently”), content consistency (ie “information changes based on where I receive it from”), and accessibility (ie “information is easily accessible such that I can find what I’m looking for easily”). Regression models revealed a negative and statistically significant relationship between information accessibility and burnout (B=-0.28, p<0.01). This association remained statistically significant when controlling for the flow and content factors. Models revealed that all three factors were positively and statistically significantly associated with teamwork experience; however, this association only remained statistically significant for information accessibility (B=-0.40, p<0.01) when controlling for the other 2 factors. CONCLUSION: Amid the heightened experience of burnout among health care workers during COVID-19, attention to the experience of frontline staff and their nuanced needs for information is vital. Leaders seeking to effectively communicate with staff amid uncertainty should be mindful of how staff experience information flow, content consistency, and especially, accessibility. Although leaders are often advised that there is no such thing as overcommunication, overwhelming information flow can be harmful if communication is irrelevant to fatigued staff. When disseminating information, leaders should check that communication is consistent across channels; otherwise, staff may feel that the content shared is inaccurate. Lastly, leaders should ensure that communicated information is easy to access, understand, and interpret.

Occupational burnout is particularly common among nurses due to their work being associated with stress, showing understanding, compassion, and commitment, along with the simultaneous need to maintain the necessary emotional distance. The aim of this review was to assess the occurrence and characterization of burnout among nurses working within neurology, geriatric care, intensive care units and with patients infected with the novel COVID-19 virus. PRISMA guidelines were used to conduct the review. The search for literature was limited to articles meeting the inclusion criteria and published from 2017 to 2022 in PubMed, Scopus, Science Direct, Google Scholar, and Wiley. A total of 768 articles from this category have been found. Ultimately, after in-depth analysis, 20 articles were included in the study. The group of respondents ranged from 49 to 3100 participants. According to the data, the percentages of nurses suffering from burnout in the presented research ranged from 14.3% to 84.7%, with the highest value of burnout among nurses who worked in the ICU during the COVID-19 pandemic. There are certain factors among nurses that significantly affect the occurrence of burnout. These include, among others, working time, age, exposure to infection and contact with infected patients, lack of training on COVID-19 prevention, providing care to an increased number of COVID-19 patients per shift, lack of personal protective equipment, lack of support of administration, lack of pay satisfaction, intrinsic motivation and turnover intention.

[This is an excerpt.] Chatbots are software applications that use steps or scripts   to   automate   natural   communication   with   users  [1,  2].  Chatbots  were  first  trialed  in  1964  with  ELIZA  created  by  Joseph  Weizenbaum,  designed  to  act  as  a  Rogerian  psychotherapist  [2,3].  Chatbots  have  been  used  in  virtually  every  industry  to  afford  customers  communication  via  messaging  without  speaking with a human associate [3]. There are over 5100 chatbot programs today, with over 100 used in healthcare   applications   [4].   In   2020,   the   chatbot   market   was   valued   at   US$   17.17   billion   and   is   projected  to  reach  $102.29  billion  by  2026.  Major  stakeholders   in   the   market   include   IBM,   Google,   Amazon,     Creative     Virtual     Ltd,     LiveChat,     and     Facebook [5]. [To read more, click View Resource.]

IMPORTANCE: Childcare stress (CCS) is high during the COVID-19 pandemic because of remote learning and fear of illness transmission in health care workers (HCWs). Associations between CCS and burnout, intent to reduce (ITR) hours, and intent to leave (ITL) are not known. OBJECTIVE: To determine associations between CCS, anxiety and depression, burnout, ITR in 1 year, and ITL in 2 years. DESIGN, SETTING, AND PARTICIPANTS: This survey study, Coping with COVID, a brief work-life and wellness survey of US HCWs, was conducted between April and December 2020, assessing CCS, burnout, anxiety, depression, workload, and work intentions. The survey was distributed to clinicians and staff in participating health care organizations with more than 100 physicians. Data were analyzed from October 2021 to May 2022. MAIN OUTCOMES AND MEASURES: The survey asked, “due to…COVID-19, I am experiencing concerns about childcare,” and the presence of CCS was considered as a score of 3 or 4 on a scale from 1, not at all, to 4, a great extent. The survey also asked about fear of exposure or transmission, anxiety, depression, workload, and single-item measures of burnout, ITR, and ITL. RESULTS: In 208 organizations, 58 408 HCWs (15 766 physicians [26.9%], 11 409 nurses [19.5%], 39 218 women [67.1%], and 33 817 White participants [57.9%]) responded with a median organizational response rate of 32%. CCS was present in 21% (12 197 respondents) of HCWs. CCS was more frequent among racial and ethnic minority individuals and those not identifying race or ethnicity vs White respondents (5028 respondents [25.2%] vs 6356 respondents [18.8%]; P < .001; proportional difference, −7.1; 95% CI, −7.8 to −6.3) and among women vs men (8281 respondents [21.1%] vs 2573 respondents [17.9%]; odds ratio [OR], 1.22; 95% CI, 1.17 to 1.29). Those with CCS had 115% greater odds of anxiety or depression (OR, 2.15; 95% CI, 2.04-2.26; P < .001), and 80% greater odds of burnout (OR, 1.80; 95% CI, 1.70-1.90; P < .001) vs individuals without CCS. High CCS was associated with 91% greater odds of ITR (OR, 1.91; 95% CI, 1.76 to 2.08; P < .001) and 28% greater odds of ITL (OR, 1.28; 95% CI, 1.17 to 1.40; P < .001). CONCLUSIONS AND RELEVANCE: In this survey study, CCS was disproportionately described across different subgroups of HCWs and was associated with anxiety, depression, burnout, ITR, and ITL. Addressing CCS may improve HCWs’ quality of life and HCW retention and work participation.

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This resource is found in our Actionable Strategies for Health Organizations: Meaningful Rewards& Recognition (Adequate Compensation)

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[This is an excerpt.] The wellbeing of health care workers is a prime concern in the functioning and performance of health care organizations. While the Triple Aim—enhancing patient experience, improving population health, and reducing health care costs—has contributed to health system reforms worldwide, scholars have asserted the need for a fourth aim to improve the professional lives of health care workers (1). Such improvements promote work engagement, job satisfaction, and talent retention; protect against the increasingly prevalent phenomenon of burnout among clinicians; and are essential for the quality and safety of care (2). They prompt health care leaders and managers to pay more attention to issues such as physicians’ experiences of autonomy loss and stress related to malpractice liability, as well as nurses’ experiences of disrespectful behaviors at work for example. More specifically, the Quadruple Aim is a call to help health care workers restore and maintain “joy and meaning in work” (3). Similarly, the Institute for Healthcare Improvement has promoted joy in work as a goal for organizations to work towards (4). [To read more, click View Resource.]

OBJECTIVE: To determine whether participation in an employer-sponsored mental health benefit was associated with improvements in depression and anxiety, workplace productivity, and ROI as well as to examine factors associated with clinical improvement. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included participants in a US workplace mental health program implemented by 66 employers across 40 states from January 1, 2018, to January 1, 2021. Participants were employees who enrolled in the mental health benefit program and had at least moderate anxiety or depression, at least 1 appointment, and at least 2 outcome assessments. INTERVENTION: A digital platform that screened individuals for common mental health conditions and provided access to self-guided digital content, care navigation, and video and in-person psychotherapy and/or medication management. MAIN OUTCOMES AND MEASURES: Primary outcomes were the Patient Health Questionnaire-9 for depression (range, 0-27) score and the Generalized Anxiety Disorder 7-item scale (range, 0-21) score. The ROI was calculated by comparing the cost of treatment to salary costs for time out of the workplace due to mental health symptoms, measured with the Sheehan Disability Scale. Data were collected through 6 months of follow-up and analyzed using mixed-effects regression. RESULTS: A total of 1132 participants (520 of 724 who reported gender [71.8%] were female; mean [SD] age, 32.9 [8.8] years) were included. Participants reported improvements from pretreatment to posttreatment in depression (b = -6.34; 95% CI, -6.76 to -5.91; Cohen d = -1.11; 95% CI, -1.18 to -1.03) and anxiety (b = -6.28; 95% CI, -6.77 to -5.91; Cohen d = -1.21; 95% CI, -1.30 to -1.13). Symptom change per log-day of treatment was similar post-COVID-19 vs pre-COVID-19 for depression (b = 0.14; 95% CI, -0.10 to 0.38) and anxiety (b = 0.08; 95% CI, -0.22 to 0.38). Workplace salary savings at 6 months at the federal median wage was US $3440 (95% CI, $2730-$4151) with positive ROI across all wage groups. CONCLUSIONS AND RELEVANCE: Results of this cohort study suggest that an employer-sponsored workplace mental health program was associated with large clinical effect sizes for employees and positive financial ROI for employers.

This resource is found in our Actionable Strategies for Health Organizations: Ensuring Physical & Mental Health (Mental Health).

In response to the acute challenges and staffing shortages of COVID-19, the Clinician Well-Being Collaborative assembled industry leaders, C-Suite members, and frontline health care workers to unite in our journey to share perspectives on challenges and barriers, pinpoint solutions, and discuss actionable strategies to mitigate burnout and strengthen the health care workforce. The free public meeting highlighted: Individual-level stressors in the context of COVID-19 Institutional-level challenges and opportunities to support workforce well-being National-level levers for improving workforce well-being, the pipeline of health workers, and stemming the shortage

OBJECTIVES: To describe relationships between compromised integrity (CI), burnout, and intent-to-leave (ITL) practice in critical care (CC) and noncritical care (non-CC) nurses and physicians. DESIGN: CC nurses (RNs) and physicians (MDs) from the American Medical Association Coping with COVID survey were matched by gender, race, years in practice, and role with non-CC clinicians to determine likelihood of ITL in relation to burnout and CI. SETTING: U.S. Healthcare organizations; July—December 2020. SUBJECTS: One hundred sixty-five CC RNs and 148 CC MDs (n = 313) matched with 165 non-CC RNs and 148 non-CC MDs from 83 healthcare organizations. MEASUREMENTS AND MAIN RESULTS: Burnout was measured with a single, validated question that mainly reflects emotional exhaustion (EE), and CI was determined by asking if respondents worried about doing things that compromised their integrity moderately or to a great extent. ITL included those moderately, likely, or definitely, intending to leave. Burnout correlated strongly with CI (tetrachoric r = 0.704 [0.606–0.803]; P < 0.001). Of 626 subjects, 59% experienced burnout, 24% CI, and 33% ITL. CC RNs experienced burnout more often (76%) than non-CC RNs (62%; P < 0.01) and CC MDs (51%; P < 0.001). CI was more frequent in CC RNs (44%) than non-CC RNs (23%) and CC MDs (16%; P < 0.001). In multivariate regressions, CC clinicians experiencing burnout had 50% greater odds of ITL than non-CC clinicians experiencing burnout; odds of ITL were substantially higher (odds ratio, 2.8–3.2) in those with CI regardless of location or burnout. In the ICU, those feeling valued by their organization had one-third the odds of ITL. CONCLUSIONS: Burnout (EE) is high (>50%) among CC RNs and MDs, which may result in losses of CC clinicians while demand rises. Preventing CI independent of burnout may reduce turnover in all settings and especially in ICUs. Feeling valued may promote staff retention.

OBJECTIVE: The objective of the present work was to characterize the coping strategies used by first responders to emergencies in the face of exposure to traumatic events. METHODS: A systematic search was performed in the databases MEDLINE (Ovid), EMBASE, LILACS (Latin American and Caribbean Literature in Health Sciences), and the Cochrane Central Registry of Controlled Clinical Trials (CENTRAL) from their inception through February 2022. First responders to emergencies with training in the prehospital area and who used validated measurement instruments for coping strategies were included. RESULTS: First responders to emergencies frequently used nonadaptive coping strategies, with avoidance or disconnection being one of the main strategies, as a tool to avoid confronting difficult situations and to downplay the perceived stressful event. The nonadaptive coping strategies used by these personnel showed a strong relationship with posttraumatic stress disorder (PTSD) symptoms, burnout syndrome, psychiatric morbidity, and chronic stress. As part of the adaptive strategies, active coping was found, which includes acceptance, positive reinterpretation, focusing on the problem, self-efficacy, and emotional support, either social or instrumental, as protective strategies for these personnel. CONCLUSIONS: Developing adaptive coping strategies, whether focused on problems or seeking emotional support, can benefit emergency personnel in coping with stressful situations. These coping strategies should be strengthened to help prevent people from experiencing long-term negative effects that could arise from the traumatic events to which they are exposed. Active coping strategies instead of avoidance strategies should be promoted.

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This resource is found in our Actionable Strategies for Public Safety Organizations: Drivers (Operational Breakdown) AND Outcomes AND Actionable Strategies (Providing a Continuum of Support)

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The Mini Z is a psychometrically sound measure of worklife and wellness in practicing clinicians. Measures in residents address slightly different issues and are moderately longer, potentially limiting response rates. We adapted the Mini Z for use in residents (the Mini ReZ), using the Mini Z core 10 questions and 5 additional questions reflecting domains identified by Trockel. Validating the new variation on the Mini Z would provide program directors the means to assess well-being within their programs (in collaboration with their residents), and determine actionable steps for improvement. The objective of this report is to demonstrate the validation of the Mini ReZ.

This narrative review aims to summarize initiatives developed during the COVID-19 pandemic to support healthcare workers' emotional well-being within the context of a preexisting framework of occupational mental health guidelines. This occupational mental health framework integrates principles from multiple disciplines to optimize prevention and management of mental health issues among employees. We conducted an online search on Medline/PubMed, Cochrane Library, and Embase for studies that reported on design or execution of medical institution-based interventions, aiming to support healthcare worker mental health during the COVID-19 pandemic. Inclusion criteria was intentionally broad in order to incorporate as many types of interventions at varying stages of development or evaluation. We included 31 studies in our review that reported on newly designed psychological support interventions for healthcare workers (HCW) during the COVID-19 pandemic. We found that most programs commonly supported HCW mental health through offering one or more of the following initiatives: expanded basic need resources/services, additional workplace training programs that bolstered professional preparedness while also indirectly boosting HCW emotional health, and/or expanded psychological support programs, such as peer support programs, psychoeducational or counseling services. Most programs, however, did not consider methods to ensure program longevity or sustainability. The COVID-19 pandemic has underscored the acuity of HCW mental health issues and is likely to leave long lasting mental health strains among HCW. This pandemic is a critical point in time to catalyze much needed progress in reducing stigma and expanding HCW mental health care access.

This resource is found in our Actionable Strategies for Health Organizations: Ensuring Physical & Mental Health (Stress/Trauma & Resilience).

During the Covid-19 pandemic, nurses requested a clean, streamlined, and intuitive view of the adult nursing assessment(s) within the electronic medical record (EMR). We created a more efficient method during a national disaster to reduce duplicative efforts and allow additional time with patients. This project was added as part of the clinically led EMR optimization strategy to eliminate unnecessary EMR assessment data elements in the adult medical, surgical, and critical care areas. This was completed in a 5-month period and decreased 20% of the data points entered by nursing. A total of 433 data points were excluded or relocated to achieve the desired result.

This resource is found in our Actionable Strategies for Health Organizations: Improving Workload & Workflows (Reducing Administrative Burdens).

In an effort to reduce unintended burdens for clinicians, health system leaders can consider de-implementing processes or requirements that add little or no value to patients and their care teams. Physicians themselves are often in the best position to recognize these unnecessary burdens in their day-to-day practice. The following list includes potential deimplementation actions to consider. Learn more on how to reduce the unnecessary daily burdens for physicians and clinicians at stepsforward.org.

‍This resource is found in our Actionable Strategies for Health Organizations: Improving Workload & Workflows (Reducing Administrative Burdens) AND  Actionable Strategies for Professional Associations: Spotlights: Professional Associations Operational Strategies (Workloads and Workflows).