How to increase the efficiency of computer-mediated nursing processes

I have just come back from Vitalis, a yearly industrial conference bringing together eHealth professionals, researchers and manufacturers in Gothenburg, Sweden. This year, I got to present some of the conclusions from my research on the effects of digitalization on nurses’ work environment (a project financed by FORTE, the Swedish Research Council for Health, Working Life and Welfare).

In my presentation, I talked about efficiency, information technology (IT) and nursing staff’s daily work life. I started by presenting the main IT-related work activities that nurses and assistant nurses in my research experience as (too) time-consuming:

  • (Excessive) clicking
  • Troubleshooting
  • Filling in electronic forms
  • Going back and forth between computer and patients
  • Duplicate charting of data on paper

This suggests that, if we manage to reduce the frequency of each of these tasks, nursing staff will be able to work more efficiently with IT. That being said, it is important to understand that this will not be achieved solely by technical improvements, such as increased usability and interoperability. (Interoperability is often presented as THE single problem behind IT’s failure to produce significant improvements in efficiency. Although it definitely is part of the problem, I just do not believe that solving it will be a panacea.) Organizational changes must also take place.

For instance, filling in forms is an almost purely organizational issue. You can always try to create better, more quickly filled-in forms, but the more fundamental problem is that it is required of nurses in spite of a phone call being more efficient and less constraining. Organizational factors also play a role in seemingly more technical issues such as excessive clicking. Excessive clicks are not only due to suboptimal design, but also to lack of system knowledge, for example in regard to the shortcuts supported by a system. This lack of knowledge is partly due to insufficient training and support (an organizational issue), and probably also to the variety of systems in use – it is difficult for anyone to become an expert in ten different systems, especially when each system uses a different “language” (this is both a technical and an organizational issue).

In conclusion: significant improvements in efficiency should be achieved if we stop focusing on technical issues only and also try to improve the spatial and social organization of work.

Image by Elías Alarcón from Pixabay