Improve nurses' well-being and joy in work: Implement true interprofessional teams and address electronic health record usability issues

摘要

The three components of the Triple - Aim enhancing the patient experience, improving population health, and reducing costs - have become the guide for optimizing healthcare system performance in the U.S. (Berwick, Nolan, & Whittington, 2008; Sikka, Morath, & Leape, 2015). The three aims are intrinsically intertwined and therefore need to be addressed simultaneously. However, constant efforts to maintain a harmonious balance of the Triple Aim is a challenge and often causes unintended consequences especially as it relates to a consistent change in clinician work processes, decreased joy in work, and burnout (Dyrbye et al., 2017; Shanafelt et al., 2016). Clinician burnout is emphasized in a call to action by the National Academy of Medicine (NAM) "to explore and address this unrecognized threat to safe, high-quality care" (Dyrbye et al., 2017). Burnout is associated with lower patient satisfaction, poor health outcomes, increased costs, and also threatens patient safety (Brigham et al., 2018). To address these issues, Bodenheimer and Sinsky (2014) proposed a fourth aim (hence, the Quadruple Aim) of improving the well-being of clinicians and staff. The added fourth aim addresses the complex and underdefined concept of professional practice work environments (PPWE). Optimized PPWEs are universally considered to be a key strategy to address the Triple Aim (Feeley, 2017). This brief will focus on two critical issues that would support clinician well-being and joy in work: 1) implementing true interprofessional teams to improve communication and quality of care while reducing costs of care; and 2) addressing the documentation burden, usability, and interoperability issues of electronic health records (EHR) through redesign so that they are care-centered.