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Appl Clin Inform 2024; 15(03): 446-455
DOI: 10.1055/s-0044-1787007
Review Article

Toward Alleviating Clinician Documentation Burden: A Scoping Review of Burden Reduction Efforts

Elizabeth A. Sloss
1   Division of Health Systems and Community Based Care, College of Nursing, University of Utah, Utah, United States
,
Shawna Abdul
2   John D. Dingell VA Medical Center, Detroit, Michigan, United States
,
Mayfair A. Aboagyewah
3   Case Management, Mount Sinai Health System, MSH Main Campus, New York, New York, United States
,
Alicia Beebe
4   Saint Luke's Health System (MO), Kansas City, Missouri, United States
,
Kathleen Kendle
5   Section of Health Informatics, El Paso VA Health Care System, El Paso, Texas, United States
,
Kyle Marshall
6   Department of Emergency Medicine, Geisinger, Danville, Pennsylvania, United States
,
S. Trent Rosenbloom
7   Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Sarah Rossetti
8   Biomedical Informatics and Nursing, Columbia University Irving Medical Center, New York, New York, United States
,
Aaron Grigg
9   Department of Informatics, Grande Ronde Hospital, La Grande, Oregon, United States
,
Kevin D. Smith
10   Department of Pediatrics, University of Chicago Medicine, Chicago, Illinois, United States
,
Rebecca G. Mishuris
11   Digital, Mass General Brigham, Somerville, Massachusetts, United States
12   Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations Funding Work by E.A.S. was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number T32NR013456 and the University of Utah Senior Vice-President for Health Sciences Research Unit and College of Nursing. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the University of Utah.
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Abstract

Background Studies have shown that documentation burden experienced by clinicians may lead to less direct patient care, increased errors, and job dissatisfaction. Implementing effective strategies within health care systems to mitigate documentation burden can result in improved clinician satisfaction and more time spent with patients. However, there is a gap in the literature regarding evidence-based interventions to reduce documentation burden.

Objectives The objective of this review was to identify and comprehensively summarize the state of the science related to documentation burden reduction efforts.

Methods Following Joanna Briggs Institute Manual for Evidence Synthesis and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we conducted a comprehensive search of multiple databases, including PubMed, Medline, Embase, CINAHL Complete, Scopus, and Web of Science. Additionally, we searched gray literature and used Google Scholar to ensure a thorough review. Two reviewers independently screened titles and abstracts, followed by full-text review, with a third reviewer resolving any discrepancies. Data extraction was performed and a table of evidence was created.

Results A total of 34 articles were included in the review, published between 2016 and 2022, with a majority focusing on the United States. The efforts described can be categorized into medical scribes, workflow improvements, educational interventions, user-driven approaches, technology-based solutions, combination approaches, and other strategies. The outcomes of these efforts often resulted in improvements in documentation time, workflow efficiency, provider satisfaction, and patient interactions.

Conclusion This scoping review provides a comprehensive summary of health system documentation burden reduction efforts. The positive outcomes reported in the literature emphasize the potential effectiveness of these efforts. However, more research is needed to identify universally applicable best practices, and considerations should be given to the transfer of burden among members of the health care team, quality of education, clinician involvement, and evaluation methods.

Keywords

electronic health record - documentation - documentation burden

Protection of Human and Animal Subjects

No human subjects were involved in the project.


Supplementary Material



Publication History

Received: 30 November 2023

Accepted: 17 April 2024

Article published online:
05 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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