CAMH tackles nurse burnout with LightsOn Network and Oracle Health Advance

“In Canada and around the world, we have an unprecedented shortage of healthcare professionals,” says Dr. Gillian Strudwick, Chief Clinical Informatics Officer (CCIO) at the Centre for Addiction and Mental Health (CAMH) in Toronto. The numbers back up this claim, with the World Health Organization (WHO) estimating that there will be a global shortfall of 15 million health workers by the end of the decade.

To make the caring profession as appealing as possible, organizations need to support those who have dedicated their careers to it. With this in mind, CAMH engaged with nurses to reduce their documentation burden so that they can spend more time with patients, attend to other tasks, and according to Gillian, “bring back some joy to nursing.”

CAMH conducted a benchmarking survey and needs assessment in 2021, which found that 34% of nurses felt like they were under significant stress, with 23% reporting one or more symptoms of burnout. The organization’s electronic health record (EHR), known as I-CARE, was described as one of the contributing factors with 29% agreeing or strongly agreeing that it contributed to their frustrations, while 44% thought it sometimes contributed to their burnout symptoms.

CAMH was not alone in this discovery about its EHR. A survey by research firm KLAS found that such systems are considered to be contributors to both physician and nurse burnout across the United States. Additionally, the 2020 National Survey of Canadian Nurses uncovered a number of barriers to full EHR adoption, including redundant data capture, the use of multiple systems and logins, and inappropriate training.

With baselines in place, CAMH was able to use LightsOn Network and Oracle Health Advance to analyze how its 1,140 nurses were working with the EHR program. They focused on several possible pain points, says Gillian. “What time during the day, evening, or night are they actually doing documentation? Are there areas that we could improve by getting rid of fields because no one uses them, as an example? These are things that we can learn by looking at our back-end data analytics.”

CAMH isn’t just looking at the quantitative data but is actively engaging with staff to collect qualitative information too. A staff nomination process allows respondents to suggest changes they would like to see, with suggestions going through a streamlined governance process. Minor changes go straight to a group of clinicians who review and decide collectively, while more complex suggestions are considered by relevant advisory groups to give the final advisory board as much information as possible.

The strategy isn’t just confined to improving I-CARE itself. “The final goal of this is really to improve communication, education, and training,” says Dr. Strudwick. “So, we are doing things like having a newsletter, mapping our education and training practices to best practices, and offering training and education for EHR use.”

CAMH’s program focuses on continual engagement to implement ongoing improvements over time and make the lives of nurses less challenging. A status check showed that progress was made already: nursing time spent in the EHR was down 2 minutes to 13 minutes per patient compared to two months earlier. Documentation time dropped by 50 seconds to 6.5 minutes. These time savings increased the number of patients being seen from 59,530 to 80,534 over the period.

“For us, it’s really important to work with Oracle Health to better understand what all the opportunities and possibilities are for being able to reduce documentation,” says Dr. Strudwick.