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EHR Usability Issues Linked to Nurse Burnout and Patient Outcomes

Nurses and other clinicians rely heavily upon the electronic health record (EHR) to provide patient care. This includes clinical decision-making, care planning, patient surveillance, medication ordering and administration, and communication with other health care team members. While data show that EHR technology usability can put added burden on clinicians, the relationships between EHR usability and the job outcomes of hospital staff nurses and surgical patient outcomes have not been explored.

A new study from the University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research (CHOPR) has investigated associations between EHR usability and nurse job outcomes (burnout, job dissatisfaction, and intention to leave) and surgical patient outcomes (inpatient mortality and 30-day readmission). The study found that employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission. EHR usability may be more important to nurse job and patient outcomes than comprehensive EHR adoption. The results have been published in the journal Medical Care.

“When the EHR system does not allow work to be performed efficiently and effectively, nurse burden increases, and patient outcomes are threatened,” says Ann Kutney-Lee, PhD, RN, FAAN, Adjunct Associate Professor, Department of Biobehavioral Health Sciences at Penn Nursing and lead investigator of the study. “Improving EHR usability may be critical to reducing nurse burnout and to realizing the full potential of EHRs to improve the quality and safety of health care.”

The study’s findings have implications for nurse turnover and its associated costs. The findings can also help EHR vendors and hospital leadership teams better understand the critical importance of nurse involvement in developing, selecting, implementing, and modifying EHR systems.

The article, “Electronic Health Record Usability: Associations With Nurse and Patient Outcomes in Hospitals,” is available online. Co-authors of the article include Margo Brooks Carthon, PhD, RN, FAAN; Matthew D. McHugh, PhD, JD, MPH, RN, CRNP, FAAN; Linda H. Aiken, PhD, RN, FAAN, FRCN; Kathryn Bowles, PhD, FAAN, FACMI; and Douglas M. Sloane, PhD, all of Penn Nursing.