Streamlining governance melds clinicians with technology

The University of Kansas Health System strengthens connections with providers by giving them more efficient structures for providing input.

Involving clinicians in data governance matters aids in transition and improves satisfaction, in the experience of the University of Kansas Health System.

Involving clinicians in data governance has the potential to improve their ability to access information, improve their trust in the data they’re using and reduce the chances of burnout.

Several industry surveys have found declining clinician satisfaction rates, a trend that was exacerbated by the COVID-19 pandemic. A recent Arch Collaborative study of 59,000 clinicians showed that 25 percent of surveyed nurses are planning to leave their jobs in the next two years. Other data points underscore the crisis in clinician retention.

These surveys highlight the importance of pinpointing and mitigating the roots of provider burnout, according to presenters in a recent presentation from the HDM KLASroom series.

In that session, Jason Hess, executive vice president of provider success at KLAS Research, and Dawn Walters, system senior director of informatics at the University of Kansas Health System, discuss some best governance practices and how they can improve the lives of clinicians.

Low trust concerns

“One of the things we found in our study was that low trust in the organization was highly correlated with the likelihood to leave,” Hess said. “We also found that establishing two-way communication goes a long way in improving clinicians’ perceptions of their organizations.”

Early Arch Collaborative data showed the University of Kansas Health System to have a strong culture of end user engagement. However, Walters and other University of Kansas leaders saw a need to streamline communication. Clinicians were eager to give feedback, but the COVID pandemic had increased their workloads, and the organization’s list of change requests had grown too long to be actionable.

“We're trying to find the right engagement point,” Walters said. “Our clinicians want their voices heard, and we need their voices heard, but they don't have a lot of time to dedicate to that. So we have to find new, creative ways to make sure we're representing their voice in an efficient manner. We want users to feel connected; we want their feedback. That's why we've put a lot of tactics into place to try and improve our governance.”

UKHS collapsed their two governance frameworks into a single governance structure with greater capability to elicit feedback from the right people, accelerate decision making and simplify implementations. Walters highlighted several components of the organization’s new governance system and processes.

Investigation teams. “We've recently set up a business informatics team to look at how we are going to make it easier for nurse managers to use their business tools in such a way that they aren’t in the systems all the time and can be available to their staff,” Walters said. “This is a new way that we're approaching support overall. We want to do anything we can to make our nurse managers more efficient and reduce their burden. Nothing is off the table.”

One process, different decision makers. “We wanted to provide a mechanism by which all the requests could come through and we could guide each request to the right level for decision making,” she added. “For our small and medium items, we really want to push that empowerment down to the right user group. For the large items, we really want to push them up to the executives because there are usually associated costs, and we want to make sure that we have resources ready to go.”

Clinician-governance connections. “A lot of what we do is promotions — trying to get information out there so people know and understand how to get connected to the governance structure and which people are a part of the governance structure,” Walters noted. “That way, the clinicians still feel like they've got a voice in the system.”

End-user testing. “When we adopt new technologies or especially new workflows, we always implement end-user acceptance testing,” she explained. “We always want to bring people in, even if they weren't a part of the initial decision. We want to make sure the users are involved in the design before it goes live.”

Three-team readiness checks before each go-live. “We do everything with our trio of informatics, operations and IT, and that really has always been our secret sauce to successful implementations – making sure all of those teams are ready to go at the right time,” Walters said. “That helps us reduce a lot of rework, overprocessing and readiness surprises.”

Hess and Walters agreed that every healthcare organization can create a better environment for clinicians if it builds on a solid governance foundation.

“By no means do we have it all figured out,” Walters said. “But we're trying to get a good footing, to at least have structure so that we can withstand the winds of the storm as we move forward.”

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