Guest Column | November 20, 2017

3 Steps To Restoring Provider Passion

Doctor On Laptop

By Dr. Tom Schwieterman, vice president, Clinical Affairs and CMO, Midmark Corporation

For those of us who entered the practice of medicine to help others, it can be incredibly disheartening when you realize you’re becoming burned out by the regulations, rules and technical challenges that keep you from focusing on what matters most: your patients.

Care provider dissatisfaction has become an epidemic problem in the United States. An August 2017 report of a three-year study of 296 clinical facilities showed that providers were increasingly prone to burnout and had perceptions that practicing medicine had become chaotic with the shift to value-based care. Whether it is the dramatic increase in clinical documentation requirements, the new reporting on clinical care metrics, or adapting to a next-generation medical home environment, one conclusion is clear: practicing medicine has become a very complicated endeavor and our care teams are struggling to adapt to the new demands placed upon them.

However, healthcare providers – and the IT teams who support them – can minimize their own risk of burnout and dissatisfaction by adopting protocols that embrace clinical standardization at the point of care and seeking workflows that empower providers and care teams to work at the top of their licenses.

  1. Explore Opportunities For Standardization
    The continuing consolidation of medical practices is occurring at such a pace that many organizations are finding it difficult to establish network-wide operational procedures that map to known clinical standards. Many health systems simply tolerate variability of workflows, care protocols, or even varied exam room equipment in the outpatient environment. Too often, variability at the point of care leads to poor patient and provider experiences. Either health systems underestimate the real impact and costs associated with this variation, or they lack the tools and teams needed to implement best practices across their network. In many cases, it is a bit of both.

Identifying opportunities for standardization allows care providers to work at the top of their license rather than worry about things like “Who do I contact for IT support at this facility?” or “Where are the gloves in this exam room?” By ensuring uniformity in care environments and workflows, health professionals can more appropriately focus instead on patient care - and find added satisfaction in their work.

The same principles of standardization ring true for connectivity. If diagnostic equipment is set up in such a way that providers use the identical devices in the same way each time, regardless of the facility, room or patient, the provider can spend more time focusing on the patient’s clinical needs. And, if it’s a task that can be automated – like vital signs acquisition – it can save that much more time and reduce unnecessary provider effort on data entry.

Clinical variation at the point of care can also impact outcomes. It has been proven that manual blood pressure readings can have inconsistent results. One research study found that automated capture tends to produce numbers significantly lower than manually taken readings by as much as -10.8/-3.1 mmHg (systolic/diastolic error).

When the data collection process is automated and standardized, consistency and precision is achieved between care sites, equipment and providers. This means increased confidence in the data collected, which ultimately leads to better clinical decisions and patient care.

  1. Use Smarter Workflows
    Just because something’s always been done one way doesn’t necessarily mean it’s the best way. I’ve visited many customers – and experienced many exam rooms on both sides of the patient-caregiver interaction. Too often, I see routine tasks at the point of care being managed differently, not just from office to office, but also from room to room. Variation like that can make things unnecessarily complex for a care team. Without a uniform and well thought-out standard workflow across the enterprise, it can be difficult to make improvements. What is needed is an agreed-upon methodology to manage the day-to-day work – a “point of care ecosystem” that makes each encounter predictable, repeatable and reliable, such that healthcare teams deliver care that leads to high patient and provider satisfaction, and ultimately, optimal clinical outcomes.

Like a great chef who takes the time to prepare and set the kitchen with the right tools in the right places before beginning a culinary masterpiece, clinicians also benefit from a setup that enables them to do their best work without thinking about whether the patient can safely access the exam table, the blood pressure was acquired properly, or the vitals data made it to the chart appropriately. A space that facilitates reliable, repeatable and consistent care – and a good experience for both patients and healthcare teams – provides the foundation upon which great clinical care is accomplished.

  1. Help Everyone Work At The Top Of Their License
    If you are a provider, a nurse or a medical assistant, think through your daily tasks. Are there tasks that you do simply because you’ve always done them? Perhaps it is taking vital signs or entering chart information, or perhaps it is obtaining the review of systems history with the patient. Then consider: is there someone else with proper training and more availability who can assume that work?

With standardized workflows and processes in place, it’s easier for healthcare providers and support staff to all work at the top of their licenses. With some effort and optimized task assignments, everyone has the opportunity to work in the most efficient way possible.

For example, consider the review of systems used by medical providers to review medical history. While the clinician needs accurate information to make a diagnosis, that information can be effectively gathered by a medical assistant and entered into an EHR so the clinician is reviewing all relevant information at one time.

Although there is no quick fix to alleviate burnout and improve provider satisfaction, thinking through the role and job requirements of the clinician and healthcare staff – and working to address them with these three tips – can help ensure good outcomes remain the focus and passion of providers. It is essential that we think of these tasks and how they are accomplished, if we are to give back the passion to a profession dedicated to caring for others.