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Nurse Burnout 2020
Sep 2020

Nurse Burnout 2020

Authored by:  Matt Brunken, 09/18/2020 | Read Time: 4 minutes

Clinician burnout is an important problem facing the healthcare industry. While previous Arch Collaborative research has explored the issue across all clinicians, this report narrows the focus specifically to nurses, one-quarter of whom report some degree of burnout. What are some of the most commonly reported causes of this burnout, and can any EHR-satisfaction best practices also help reduce burnout?

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percent of nurses experiencing burnout

Note: The Arch Collaborative survey asks respondents to identify their personal level of burnout. Any respondent who selects one of the latter three responses is categorized as experiencing burnout.

  • I enjoy my work. I have no symptoms of burnout.
  • I am under stress and don’t always have as much energy as I did, but I don’t feel burned out.
  • I am definitely burning out and have one or more symptoms of burnout (e.g., emotional exhaustion).
  • The symptoms of burnout that I am experiencing won’t go away. I think about work frustrations a lot.
  • I feel completely burned out. I am at the point where I may need to seek help.

A Note about This Research

Though the Arch Collaborative’s primary focus is improving the EHR experience, the Arch Collaborative survey includes two questions about clinician burnout derived from the American Medical Association’s Mini Z study and correlated with the Maslach Burnout Inventory. While analyzing nurse responses to these questions can yield interesting insights, this report is not a comprehensive analysis of the causes of burnout, nor are its recommendations intended to be the primary solutions for this complex problem. Additionally, please note that most data in this report was collected prior to the COVID-19 pandemic. KLAS is actively measuring the impact of COVID-19 on burnout, and we hope to publish these findings at a future time.

EHR Satisfaction Is Not Strongly Correlated to Nurse Burnout

There is a slight, negative relationship between EHR satisfaction and nurse burnout, suggesting that as nurses become burned out, their EHR satisfaction declines. However, it is important to note that the quantitative relationship is quite weak—only about 5% of the variation in an organization’s Net EHR Experience Score can be attributed to burnout rate. So what factors do have a significant impact on burnout? Nurse respondents to the Arch Collaborative survey most commonly cite a chaotic work environment, time-consuming bureaucratic tasks, and a lack of effective teamwork. EHR-related contributors are among the least frequently selected. This suggests that the EHR as a whole may not be a significant factor in nurse burnout, and organizations should focus most burnout-reduction efforts on other areas.

net ehr experience score vs burnout rate

Note: Each point on this chart represents a single organization in the Arch Collaborative and plots that organization’s average rate of nurse burnout and average Net EHR Experience Score (NEES) for nurses.

Note: The Net EHR Experience Score (NEES) is a snapshot of nurses’ overall satisfaction with the EHR. The survey asks respondents to rate factors such as the EHR’s efficiency, functionality, impact on care, and so on. The NEES is then calculated by subtracting the percent of negative user feedback from the percent of positive user feedback. Scores can range from -100% (all negative feedback) to +100% (all positive feedback).

contributors to burnout

Note: Respondents could select multiple options.

Can EHR-Satisfaction Best Practices Also Help Reduce Burnout?

Despite the weak relationship between nurse burnout and EHR experience, the Arch Collaborative data has revealed that some practices that increase EHR satisfaction also lead to reduced burnout among nurses. For example, nurses who feel their documentation requirements are reasonable are less likely to be burned out. This suggests that reducing the documentation burden on nurses can help alleviate feelings of burnout. A case study from Peninsula Regional Medical Center demonstrates how the organization reduced their nursing documentation burden.

Another metric from the Arch Collaborative survey that impacts nurse burnout is how strongly nurses agree or disagree that their organizational leadership and IT department have implemented and supported the EHR well. This falls under the area of shared EHR ownership, where respondents are asked to rate three EHR stakeholders: themselves, their EHR vendor, and their organizational leadership/IT. Ratings for their organization’s leadership/IT are most closely correlated with a nurse respondent’s likelihood of being burned out—only 12% of nurses who strongly agree that leadership/IT delivers well experience feelings of burnout, well below the Collaborative average of 25%; conversely, 41% who strongly disagree report being burned out. Thus, organizations that focus on improving nursing trust in leadership/IT may see reduced levels of burnout. For best practices regarding leadership and IT, see “Organization Culture: The X-Factor of EHR Success.”

percent of nurses reporting burnout by agreement that documentation burden is reasonable
percent of nurses reporting burnout by agreement that organization leadership it delivers well

Key Takeaways & Further Research

Overall, the key takeaways for organizations to draw from this report are:

  1. The majority of nurses do not appear to be experiencing burnout. While this is good news, there is still room for improvement for the 25% of nurses who do report symptoms.
  2. There is only a small correlation between nurse burnout and EHR satisfaction, suggesting that organizations should focus most of their burnout-reduction efforts on other areas.
  3. Decreasing nurses’ documentation burden and increasing their trust in organizational leadership/IT may help reduce their feelings of burnout.

For a broader examination of burnout across all types of clinicians, see KLAS’ 2019 report “Clinician Burnout.” Findings from that research reveal some best practices of health systems who experience lower-than-average burnout rates:

  • Improve EHR proficiency through effective training
  • Ensure documentation completion
  • Give clinicians a voice in EHR governance
  • Build strong teams
  • Be deliberate about workloads
  • Establish a culture where patients are truly the focus
  • Strengthen communication skills for all caregivers
  • Monitor and support improvements in team strength and culture
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2019 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.