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DOI: 10.1055/s-0044-1787007
Toward Alleviating Clinician Documentation Burden: A Scoping Review of Burden Reduction Efforts
Funding Work by E.A.S. was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number T32NR013456 and the University of Utah Senior Vice-President for Health Sciences Research Unit and College of Nursing. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the University of Utah.
Abstract
Background Studies have shown that documentation burden experienced by clinicians may lead to less direct patient care, increased errors, and job dissatisfaction. Implementing effective strategies within health care systems to mitigate documentation burden can result in improved clinician satisfaction and more time spent with patients. However, there is a gap in the literature regarding evidence-based interventions to reduce documentation burden.
Objectives The objective of this review was to identify and comprehensively summarize the state of the science related to documentation burden reduction efforts.
Methods Following Joanna Briggs Institute Manual for Evidence Synthesis and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we conducted a comprehensive search of multiple databases, including PubMed, Medline, Embase, CINAHL Complete, Scopus, and Web of Science. Additionally, we searched gray literature and used Google Scholar to ensure a thorough review. Two reviewers independently screened titles and abstracts, followed by full-text review, with a third reviewer resolving any discrepancies. Data extraction was performed and a table of evidence was created.
Results A total of 34 articles were included in the review, published between 2016 and 2022, with a majority focusing on the United States. The efforts described can be categorized into medical scribes, workflow improvements, educational interventions, user-driven approaches, technology-based solutions, combination approaches, and other strategies. The outcomes of these efforts often resulted in improvements in documentation time, workflow efficiency, provider satisfaction, and patient interactions.
Conclusion This scoping review provides a comprehensive summary of health system documentation burden reduction efforts. The positive outcomes reported in the literature emphasize the potential effectiveness of these efforts. However, more research is needed to identify universally applicable best practices, and considerations should be given to the transfer of burden among members of the health care team, quality of education, clinician involvement, and evaluation methods.
Protection of Human and Animal Subjects
No human subjects were involved in the project.
Publication History
Received: 30 November 2023
Accepted: 17 April 2024
Article published online:
05 June 2024
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