ITEP Documentation Burden

More Than Documentation Burden Creating Burnout:
What Systems Must do to Achieve Safe, Efficient Patient Care Using Technology

Purpose Statement:

As a result of the COVID-19 pandemic, the documentation burden for nurses has amplified. This policy dialogue will engage participants in discussion of strategies that leverage technology and system response to reduce burnout thereby contributing to safe patient care and clinician well-being. The underlying issues surrounding burnout, distress, and documentation burden will be explored, specifically relating to how technological stress impacts clinicians. This dialogue will address three perspectives, including local/organizational, state, and national.

Learning Outcomes:

As a result of participating in this policy dialogue, learners will:

1. Describe technology’s effect on providers and the association to burnout, the workforce shortage, and the potential for negative impact.
2. Examine factors related to documentation burden and potential solutions to reduce burden.
3. Identify actions, interventions, and systemic changes needed to support providers and the delivery of safe patient care.
   

Featured Speakers

	Victoria (Vicky) L. Tiase, PhD, RN-BC, FAMIA, FNAP, FAAN, is the Strategic Director for Digital Health and Assistant Professor of Biomedical Informatics at the University of Utah. Most recently, she was the Director Research Science and Informatics Strategy at NewYork-Presbyterian Hospital and Assistant Professor of Health Informatics at Weill Cornell Medicine. Her expertise ranges from leading EHR implementations, leveraging patient-generated health data, to mentoring digital health startups. Dr. Tiase serves on the boards of the Alliance for Nursing Informatics, AMIA, FNINR, and the editorial board of the Journal of the American Medical Informatics Association. She was appointed as the informatics expert to the National Academy of Medicine’s Future of Nursing 2030 Committee to envision the nurse’s role in using technology to tackle disparities, promote health equity, and create healthier communities. She completed her BSN at the University of Virginia, MSN at Columbia University, and PhD from the University of Utah.
	Stephanie (Steph) Hoelscher, DNP, RN-BC, CPHIMS, CHISP, FHIMSS, is an Associate Professor of Graduate Informatics with Texas Tech University Health Sciences Center in Lubbock, Texas. She is board-certified in Nursing Informatics by the American Nurses Credentialing Center as well as certified and a Fellow in Healthcare Information and Management Systems Society (HIMSS).  Dr. Hoelscher is a registered nurse with almost 30 years of experience in oncology, trauma, and informatics. Her informatics areas of expertise include EHR workflow optimization, infectious disease clinical decision support, using artificial intelligence in academia, and reducing clinician documentation burden. She currently serves on the HIMSS Nursing Informatics Networking and Education Task Force and is the chair of the American Nursing Informatics Association (ANIA) Social Media committee. Dr. Hoelscher is the principal investigator for the ongoing national ANIA/ANI study entitled, Nursing Documentation: Reducing Burden in a Time of Crisis.
	Jess Dillard-Wright, PhD, MA, RN, CNM (she/they) lives, works, and plays in Western Massachusetts. She/they are white, fat, genderqueer, queer, and disabled assistant professor at University of Massachusetts Amherst Elaine Marieb College of Nursing. Jess is an affiliate of the University of Massachusetts IALS Center for Personalized Health Monitoring, co-leading the ethics arm of a collaborative research thrust, Health Tech for the People. She/they are also a 2023 Public Interest Technology (PIT@UMass) fellow working with a team of transdisciplinary collaborators in thinking about communicating complex ideas, the use of black boxed technologies in/as healthcare and for health, and new material/care ethics in accountable and community-focused ways, focused on reproductive health and death care. Jess was the 2021/22 fellow for the University of California Irvine Center for Nursing Philosophy. Jess also serves on the American Nurses Association Ethics Advisory Board. She/they work in collaboration with folks across the country and around the world to first imagine and then build worlds that are just, equitable, sustainable. Examples of this work include Nursing Mutual Aid, Call to Action for Health+Liberation alternate nurses week actions, and an ongoing community with the Compost Collaborative. More about Jess’s visions for a collective future can be found in Nursing a Radical Imagination: Moving from Theory and History to Action and Alternate Futures, an anthology she co-edited published by Routledge.
	Allison Norful, PhD, RN, ANP-BC, FAAN, is an Assistant Professor at the Columbia University School of Nursing. Over the past 20 years, Dr. Allison Norful has held numerous clinical, administrative and research positions. She is a board-certified adult nurse practitioner whose past appointments have included Assistant Director of Patient Care Services in the Northwell Health System as well as Medical Production Staff at NBC Studios in Rockefeller Center. After earning her PhD from Columbia University and completing a postdoctoral fellowship at the CUIMC Irving Institute for Clinical and Translational Research, Dr. Norful joined Columbia Nursing’s faculty with a joint appointment as a clinical nurse scientist across the NewYork-Presbyterian Hospital enterprise. Dr. Norful has increasingly been recognized as a leading international researcher investigating the influence of nursing and NP work environment factors on clinician health outcomes including physiologic stress, burnout, workforce turnover, and suicide. She is the developer of several instruments including the Provider Co-Management Index, now being used across 5 countries in both research and clinical settings. More recently, Dr. Norful has served as a content expert for PressGaney Associates, was named co-chair of an NIH CTSA Working Group, and elected as a Fellow in the New York Academy of Medicine and American Academy of Nursing.
	Mari Tietze, PhD, RN-BC, FHIMSS, FAAN, is the recipient of the Myrna R. Pickard Endowed Professorship at the University of Texas at Arlington (UTA) College of Nursing and Health Innovation (CONHI). In that role, she is the Affiliate, representing nursing, to the UTA Multi-Interprofessional Center for Health Informatics (MICHI), a collaboration among numerous health informaticists.  She is also the director of the graduate certificate and master’s in nursing (MSN) Health Informatics at UTA CONHI.  Dr. Tietze was co-investigator in two Texas-wide multi-method studies to examine over 1,000 nurses’ experiences using their electronic health records (EHRs).  She is co-author of the 3-time AJN Book of the Year, Nursing Informatics for the Advanced Practice Nurse: Patient Safety, Quality, Outcomes, and Interprofessionalism.  Dr. Tietze received her BSN from Washburn University, her MSN from Kansas University, and her PhD from Texas Woman’s University College of Nursing.  She is a Fellow of the Healthcare Information and Management Systems Society and is certified in nursing informatics from the American Nurses Credentialing Center.  Dr. Tietze is a Fellow in the American Academy of Nursing.