KLAS Arch Collaborative Nursing Guidebook 2024

What Is the Arch Collaborative Nursing Guidebook?

The 2024 Arch Collaborative Nursing Guidebook is based on the feedback of around 75,000 nurses who have measured their EHR satisfaction via the KLAS Arch Collaborative over the last three years; in this time, nurses’ satisfaction with their EHR experience has gradually increased. This data has enabled the Arch Collaborative to identify universal best practices that any healthcare organization—regardless of their size, region, or EHR vendor—can use to further improve their nurses’ EHR satisfaction.

The Cost of Nurse Burnout

EHR Education: Establishing & Sustaining User Mastery & Efficiency

Onboarding EHR Education

Onboarding EHR education most commonly refers to the EHR training offered to newly hired clinicians during their first 90 days at an organization. Nurses who are satisfied with their initial training report a 135% higher agreement rate that their EHR is easy to learn. However, 42% of nurses feel their initial training was insufficient, and 32% report their training wasn’t specific to their workflow.

Ongoing EHR Education

Ongoing EHR education is an essential component of user mastery and efficiency. Nurses who are satisfied with ongoing training report a 115% higher agreement rate that the EHR enables efficiency. Unfortunately, 38% of nurse respondents don’t agree that their ongoing training is sufficient. Organizations with the most-highly satisfied nurses typically use three methods of ongoing training.

EHR Governance: Supporting Nurse Success through Shared Ownership

Although nurse EHR satisfaction has increased in recent years, many nurses still feel they don’t have shared ownership over EHR governance—which is the strategic and operational framework established within a healthcare organization to oversee system management, use, and optimization. Organizations’ governance strategies should involve four elements: (1) decision-making, (2) training/education oversight, (3) accountability, and (4) continuous improvement. 46% of surveyed nurses do not agree that their organization implemented, trains on, and supports the EHR well. Additionally, 56% of nurses report they don’t have an EHR liaison assigned to their area. Having a liaison who provides status updates, collects and shares nurse feedback, and communicates about changes can help address challenges related to governance.

EHR Personalization: Increasing Efficiency by Meeting Individual User Needs

Personalization allows healthcare organizations to meet the needs of individual end users without making significant changes to the EHR. On average, nurses who have personalized their EHR have a Net EHR Experience Score that is 45 points higher (on a -100 to 100 point scale) than those who have not employed personalization.

About This Report

KLAS surveys clinicians about their EHR experience and satisfaction using our Arch Collaborative EHR Experience Survey. This survey captures clinician feedback on various metrics, including 11 metrics (see the accompanying chart) that are aggregated into an overall Net EHR Experience Score (NEES). The NEES represents a snapshot of the clinician’s overall satisfaction with the EHR environment at their organization and can range from -100 (all negative feedback) to 100 (all positive feedback).

The data in this report was collected from 171 healthcare organizations between 2021 and 2023—historical data (prior to 2021) is not included. If an organization has surveyed their clinicians multiple times, only the most recent full measurement is included.

Additionally, the insights in this guidebook draw from the following sources:

• The Arch Collaborative Executive Survey, which asks healthcare leadership teams about their organizational EHR practices and processes. The Executive Survey data in this report was collected from 81 executives between 2021 and 2023.
• Arch Collaborative member case studies, which highlight top-performing members of the Arch Collaborative that have worked with their EHR vendor or third-party vendor to improve different aspects of the EHR experience for nurses.

What Is the KLAS Arch Collaborative?

The Arch Collaborative is a group of healthcare organizations committed to improving the EHR experience through standardized surveys and benchmarking. To date, almost 350 healthcare organizations have surveyed their end users and over 500,000 clinicians have responded. Reports such as this one seek to synthesize the feedback from these clinicians into actionable insights that organizations can use to revolutionize patient care by unlocking the potential of the EHR.