Abstract

BackgroundThe COVID-19 pandemic spread worldwide in 2020. Notably, in the countries dealing with massive casualties, clinicians have worked in new conditions characterized by a heavy workload and a high risk of being infected. The issue of clinician burnout during the pandemic has attracted considerable attention in health care research. Electronic health records (EHRs) provide health care workers with several features to meet a health system’s clinical needs.ObjectiveWe aim to examine how the use of EHR features affects the burnout of clinicians working in hospitals that have special wards for confirmed COVID-19 cases.MethodsUsing an online survey, we collected data from 368 physicians, physician assistants, and nurses working in six hospitals that have implemented EHRs in the city of Tehran in Iran. We used logistic regression to assess the association between burnout and awareness of EHR features, EHR system usability, concerns about COVID-19, technology solutions, hospital technology interventions, hospital preparedness, and professional efficacy adjusted for demographic and practice characteristics.ResultsThe primary outcome of our study was self-reported burnout during the COVID-19 pandemic. Of the 368 respondents, 36% (n=134) reported having at least one symptom of burnout. Participants indicated that the leading cause of EHR-related stress is inadequate training for using technology (n=159, 43%), followed by having less face-to-face time with patients (n=140, 38%). Positive perceptions about the EHR’s ease of use were associated with lower odds of burnout symptoms. More interventions, such as clear communication of regulations; transparency in policies, expectations, and goals regarding the use of technology in the clinical workflow; and hospital preparedness to cope with the challenges of the pandemic, were associated with lower odds of burnout.ConclusionsThe use of EHR applications, hospital pandemic preparation programs, and transparent technology-related policies and procedures throughout the epidemic can be substantial mitigators of technology-based stress and clinician burnout. Hospitals will then be better positioned to devise or modify technology-related policies and procedures to support physicians’ and nurses’ well-being during the COVID-19 pandemic. Training programs, transparency in communications of regulations, and developing a clear channel for informing clinicians of changes in policies may help reduce burnout symptoms among physicians and nurses during a pandemic. Providing easily accessible mentorship through teleconsultation and 24-hour available information technology support may also help to mitigate the odds of burnout.

Highlights

  • Burnout has attracted more attention in health care since it is considered a trigger for health care professionals’ physical and mental problems [1]

  • Positive perceptions about the Electronic health record (EHR)’s ease of use were associated with lower odds of burnout symptoms. More interventions, such as clear communication of regulations; transparency in policies, expectations, and goals regarding the use of technology in the clinical workflow; and hospital preparedness to cope with the challenges of the pandemic, were associated with lower odds of burnout

  • In this study of 368 clinicians working in hospitals in Tehran, we found that EHR usability, technology-based hospital interventions, hospital preparedness, and level of concern about COVID-19 were significantly associated with workplace burnout

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Summary

Introduction

Burnout has attracted more attention in health care since it is considered a trigger for health care professionals’ physical and mental problems [1]. Clinicians’ burnout may negatively affect the quality of care, cost of health care delivery, productivity, and patient satisfaction [2]. COVID-19 was first identified in Wuhan, China and has since become a global pandemic that has spread to more than 150 countries and affected over 9.6 million people worldwide [5]. With the spread of the COVID-19 pandemic, burnout syndrome and physical exhaustion among clinicians have become even more pronounced. Declaring the COVID-19 outbreak as a pandemic by the World Health Organization has raised concerns about its possible detrimental effects on clinicians’ workload and well-being [6]. In the countries dealing with massive casualties, clinicians have worked in new conditions characterized by a heavy workload and a high risk of being infected. The issue of clinician burnout during the pandemic has attracted considerable attention in health care research. Electronic health records (EHRs) provide health care workers with several features to meet a health system’s clinical needs

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