Combating clinical staff turnover with an effective EHR training strategy
Training is an investment in not only the efficiency of clinicians, but also their ability to deliver quality care to their patients.
Turnover has always been a challenge in healthcare, but COVID-19 has put the issue front and center.
The 2022 NSI National Health Care & RN Retention Report estimates that hospital turnover increased by 6.4 percentage points from 2021 to 2022; it currently stands at 25.9 percent.
The cost of turnover can also be staggering, with the average hospital spending $5.2 million to $9 million on it every year. Training a constant stream of new clinicians is particularly costly. This burden tends to fall heaviest on nursing departments, which have seen a higher rate of turnover than all other clinical groups.
Turnover is a complicated, industrywide problem, but healthcare organizations can lessen its impact. Onboarding and training clinicians represent a significant portion of the cost of turnover. But with the right tools, organizations can reduce the time it takes to onboard new hires and develop an effective electronic health record training strategy that leads to higher clinician satisfaction.
Understanding the increase in turnover
Many elements contribute to the increased level of turnover in healthcare. KLAS Research recently published a report outlining several key metrics that are most correlated to increases in turnover. Here are some of the top issues among those clinicians reporting plans to leave their organization:
- Feeling completely burned out: Burnout is a multifaceted issue affecting almost every aspect of the care continuum. According to KLAS Research, burnout has spiked since the start of the pandemic from approximately 25% of clinicians reporting burnout to approximately one-third. While the pandemic is a primary driver, the increasingly inefficient use of EHRs and IT tools and after-hours workloads continue to be significant contributors.
- Distrust in the IT/organizational leadership: A key factor in whether a clinician feels burned out and has plans to leave their organization comes down to their trust in IT and organizational leadership. By prioritizing the EHR training strategy and clinician support at the leadership level, organizations can make strides in improving trust.
- Dissatisfaction with EHRs: While EHRs are a very effective tool, they also are a key source of frustration and burnout among clinicians. Improvements in training have been shown to improve EHR satisfaction. According to a 2021 KLAS report, several healthcare organizations, including Intermountain Healthcare, have seen an improvement in overall satisfaction through improvements to training.
- Dissatisfaction with EHR training: KLAS Research data shows that high quality initial and ongoing training is the primary driver of EHR satisfaction. Improving how a clinician feels about training within their organization can have dramatic effects on lowering turnover.
Clinician turnover is a multifaceted issue that will require an array of solutions, including improving the training experience for clinicians.
A successful EHR training strategy
While there’s not a one-size-fits-all method for successful training, organizations should focus on a few key elements, including:
A strong ‘why’: Onboarding is a great opportunity to build unity for clinicians through helping them understand the “why” behind the workflows. EHRs are used differently at different organizations. Helping clinicians understand why they are expected to document in a certain way can help reduce the use of workarounds, build alignment and foster trust.
Checks and balances: Clinicians are eager to get started, but they can easily become frustrated without proper training. Organizations that utilize assessments with built-in follow-up training report greater knowledge retention.
Workflow specific: Initial and ongoing training need to address the specific clinical focus area. Nurses and physicians do not utilize the same workflows and thus need training specific to their role and department. When training is mostly tailored to physicians, nurses feel their needs are not met. Gathering clinical input for content creation is a key component of effective training. One common frustration is that the screen shares used in training are different than what a clinician encounters on the floor.
Timing: Training has historically been a time-consuming, in-person event that hasn’t always met the needs of clinicians. The 2019 pandemic forced organizations to start looking at other options, and many started to utilize virtual and online training. However, these options have not been particularly well received because they fail to address the needs of clinicians who are struggling at the point-of-care. To deliver training to a clinician at their moment of need, some organizations have used rounding informaticists, which can be costly. And this approach is only effective in an acute care setting where access to these resources is available. So it’s not practical for smaller hospitals and clinics, or for providers working the night shift.
Agile: EHRs are constantly changing. Some EHR suppliers roll out quarterly updates that change workflows, which means clinicians must keep up. Many organizations don’t offer much more than email updates to communicate the changes that have been made, leaving clinicians frustrated that they are constantly creating new muscle memory in their documentation. Plus, regulatory changes can impact how clinicians interact with their EHR system. Staying on top of all these changes can be an overwhelming task for clinicians.
Creating a comprehensive EHR training strategy is one of the most important ways that organizations can show their commitment to the success of their clinicians. Training is an investment in not only the efficiency of clinicians, but also their ability to deliver quality care to their patients.
Choosing a learning platform
To create a successful EHR training strategy, organizations need to select the right comprehensive learning platform that can complement their learning management system to speed up onboarding and manage on-the-job, formal and informal ongoing training.
The platform should contain a content creation tool that enables training teams to efficiently produce content.
To minimize the time end users spend on redundant or irrelevant lessons, courses should be tailored to the user’s role, specialty or department. Efficient training has been proven to boost Net EHR Satisfaction Scores and get clinicians on the job faster.
One of the top healthcare system challenges is high turnover, so many organizations are looking for ways to reduce its impact. Better training plays a vital role in the clinician onboarding experience, minimizing how much time they spend off the job.
Jordan Edwards is marketing manager at uPerform.
See related story: Can better EHR training reduce physician burnout?