The Healthcare Management Council, Inc. Delivering Cost and Quality Benchmarks for your Hospital organization.

HMC:Nurses frustrated by documentation and systems

Supplies, computer systems, and other issues keep nurses from bedside

NEEDHAM, MASS. –  June 22, 2010 – The Healthcare Management Council, Inc. (HMC) has found time-consuming and redundant patient processing and documentation are among the biggest time-wasters for nurses.

Time away from patients to complete redundant or non-medical tasks is a huge source of frustration to nurses. It can reduce quality of care, create patient dissatisfaction, and lead to staff turnover, says Michelle Gray-Bernhardt, an HMC knowledge manager. “Time-wasting is a serious problem for nurses. They are eternally frustrated by the tasks that take them away from patients. Their aggravation can create low morale and that causes turnover. That means you’re spending time, money, and resources to hire and train more nurses. That’s expensive, and it’s not always an easy thing to do, given today’s healthcare climate,” she says.

To address this, HMC recently sponsored an online survey on the KnowledgeWeb portal to pinpoint where the greatest inefficiencies were.  “We asked nurses what tasks take them away from the patient bedside and feel like time-wasters,” Gray-Bernhardt says. “A wide-ranging sample of nurses from various units chose broad categories, such as documentation, gathering supplies, physician interaction, patient flow, and the lack of support staff.”

And the winners are….

Nurses outlined the greatest time-wasters as follows below. Each category is ranked  in the order of the percentage of nurses that selected it:

Charts and documentation (55%). These are interrelated topics: Overall, documentation creates inefficient processes, but especially when nurses are working with computer systems. Nurses cited electronic documentation as the worst time waster – this includes having to enter data twice into separate incompatible systems, or working with “hybrid” paper and electronic systems.

“Anything that requires duplication and looking at different sources of information is a waste of time,” notes Gray-Bernhardt. “In some cases, nurses enter patient status information on one system, and then have to reenter the identical data on another system.” Nurses were also frustrated when discovering that charts were missing or incomplete, or by situations that required them to add what they considered excess information.

Finding and gathering supplies and equipment (19%). Whether seeking supplies or equipment, time spent searching equals time spent away from patients. Hospitals should look at improving utilization patterns to ensure the availability of supplies in the particular units where nurses are.

Patient flow (15%). Nurses in medical and surgical groups said waiting for – and sometimes admitting – patients was a major time-waster. Also in this category were the unavailability of exam or treatment rooms and having anomalous patients on units. Sometimes nurses found they needed to find patients and retrieve them from other units, as well as locate beds for them when their own units had no available space.

Physician interaction (15%). Waiting for communication with physicians is highly frustrating for nurses. Moreover, doctors and hospitals are behind the curve when it comes to high speed electronic communications. Nurses often wait for return phone calls, and find it challenging to gather post-round information, medication orders, discharge orders, and other necessary information.

Redundant and decentralized communication with families (11%). Patients’ family members call frequently and unexpectedly, and when there is no clear family spokesperson, this leads to redundant communications. Factor in that multiple family members will call daily with status requests and discharge information, and the result is that nurses spend too much time providing the same data.

HMC offers solutions to these challenges and many others on its KnowledgeWeb portal, available to clients.