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"Like One Long Battle:" Employee Perspectives of the Simultaneous Impact of COVID-19 and an Electronic Health Record Transition

dc.contributor.authorRucci, Justin M
dc.contributor.authorBall, Sherry
dc.contributor.authorBrunner, Julian
dc.contributor.authorMoldestad, Megan
dc.contributor.authorCutrona, Sarah L
dc.contributor.authorSayre, George
dc.contributor.authorRinne, Seppo
dc.date.accessioned2023-12-05T14:30:38Z
dc.date.available2023-12-05T14:30:38Z
dc.date.issued2023-10-05
dc.identifier.citationRucci JM, Ball S, Brunner J, Moldestad M, Cutrona SL, Sayre G, Rinne S. "Like One Long Battle:" Employee Perspectives of the Simultaneous Impact of COVID-19 and an Electronic Health Record Transition. J Gen Intern Med. 2023 Oct;38(Suppl 4):1040-1048. doi: 10.1007/s11606-023-08284-3. Epub 2023 Oct 5. PMID: 37798583; PMCID: PMC10593661.en_US
dc.identifier.eissn1525-1497
dc.identifier.doi10.1007/s11606-023-08284-3en_US
dc.identifier.pmid37798583
dc.identifier.urihttp://hdl.handle.net/20.500.14038/52840
dc.description.abstractBackground: Healthcare organizations regularly manage external stressors that threaten patient care, but experiences handling concurrent stressors are not well characterized. Objective: To evaluate the experience of Veterans Affairs (VA) clinicians and staff navigating simultaneous organizational stressors-an electronic health record (EHR) transition and the COVID-19 pandemic-and identify potential strategies to optimize management of co-occurring stressors. Design: Qualitative case study describing employee experiences at VA's initial EHR transition site. Participants: Clinicians, nurses, allied health professionals, and local leaders at VA's initial EHR transition site. Approach: We collected longitudinal qualitative interview data between July 2020 and November 2021 once before and 2-4 times after the date on which the health system transitioned; this timing corresponded with local surges of COVID-19 cases. Interviewers conducted coding and analysis of interview transcripts. For this study, we focused on quotes related to COVID-19 and performed content analysis to describe recurring themes describing the simultaneous impact of COVID-19 and an EHR transition. Key results: We identified five themes related to participants' experiences: (1) efforts to mitigate COVID-19 transmission led to insufficient access to EHR training and support, (2) clinical practice changes in response to the pandemic impacted EHR workflows in unexpected ways, (3) lack of clear communication and inconsistent enforcement of COVID-19 policies intensified pre-existing frustrations with the EHR, (4) managing concurrent organizational stressors increased work dissatisfaction and feelings of burnout, and (5) participants had limited bandwidth to manage competing demands that arose from concurrent organizational stressors. Conclusion: The expected challenges of an EHR transition were compounded by co-occurrence of the COVID-19 pandemic, which had negative impacts on clinician experience and patient care. During simultaneous organizational stressors, health care facilities should be prepared to address the complex interplay of two stressors on employee experience.en_US
dc.language.isoenen_US
dc.relation.ispartofJournal of General Internal Medicineen_US
dc.relation.urlhttps://doi.org/10.1007/s11606-023-08284-3en_US
dc.rightsOpen Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativeco mmons.org/licenses/by/4.0/.en_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectCOVID-19 pandemicen_US
dc.subjectburnouten_US
dc.subjectelectronic health recordsen_US
dc.subjectinformaticsen_US
dc.subjectorganizational changeen_US
dc.title"Like One Long Battle:" Employee Perspectives of the Simultaneous Impact of COVID-19 and an Electronic Health Record Transitionen_US
dc.typeJournal Articleen_US
dc.source.journaltitleJournal of general internal medicine
dc.source.volume38
dc.source.issueSuppl 4
dc.source.beginpage1040
dc.source.endpage1048
dc.source.countryUnited States
dc.identifier.journalJournal of general internal medicine
refterms.dateFOA2023-12-05T14:30:39Z
dc.contributor.departmentPopulation and Quantitative Health Sciencesen_US


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Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativeco mmons.org/licenses/by/4.0/.
Except where otherwise noted, this item's license is described as Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativeco mmons.org/licenses/by/4.0/.