Abstract
INTRODUCTION: EHRs are associated with improved patient outcomes, but the inefficiency of time spent on EHR may contribute to healthcare provider stress, exhaustion and burnout. EHR use associates with higher prevalence of burnout in Neonatal Intensive Care Units (NICUs), but the relationship between EHR use and burnout in other inpatient settings remains unclear. This study sought to identify subjective and objective markers of EHR use associated with provider burnout in the pediatric inpatient setting. METHODS: Attendings, fellows, hospitalists, and nurse practitioners from a quaternary children’s hospital who work primarily in the inpatient setting were included in our study. We collected five months (June-October 2020) of EHR-use and schedule data for these providers. This data was then linked to 2020 annual wellness survey (September-October) data which included a 4-item EHR experience score and the Stanford Professional Fulfillment Index. We evaluated associations using Pearson correlation, lasso regression for variable selection, and mixed effect linear regression. RESULTS: Of 246 eligible providers, 179 (73%) responded to the survey. Average EHR experience score was 2.2±0.8, range 0-4, and average burnout score was 1.1±0.7, range 0-4, with burnout prevalence of 32%. Average number of notes/orders placed was independently associated with the EHR experience scores (coefficient -0.013, p=.04). EHR experience scores were negatively correlated with provider burnout scores (r -0.18, p=.03), but not independently associated after adjustment for work setting and role. EHR task count per patient, division, and role were selected as important predictor variables for burnout via lasso regression. Among these, the Pediatric Intensive Care Unit (PICU) division was independently associated with higher burnout scores (coefficient 0.36, p=.016). None of the EHR use measures were independently associated with burnout. CONCLUSIONS: Burnout is prevalent among inpatient providers, and being a PICU provider was independently associated with burnout. Although routinely collected EHR use measures may associate with negative EHR experience, we did not identify independent associations with burnout among this sample of inpatient pediatric providers. Larger studies are needed to investigate this relationship further.
