Survey Indicates Nurses Favor Advanced Electronic Health Records Systems

Adoption of more comprehensive electronic health record (EHR) systems leads to greater satisfaction and use among nurses, as well as higher-quality care for patients, according to an AHRQ-funded study in Applied Clinical Informatics. Researchers surveyed more than 12,000 nurses in 157 hospitals with comprehensive EHR systems and 196 hospitals with basic systems or less. Hospitals with comprehensive systems had fewer workflow disruptions and staff concerns about EHR use. Overall, nurses working in better environments were significantly less likely to evaluate the EHR system negatively compared with nurses working in less favorable environments. Researchers concluded the findings suggest advanced EHR systems are associated with more positive usability ratings and higher nurse-reported quality of care. Access the abstract.

2019 Jan;10(1):129-139. doi: 10.1055/s-0039-1678551. Epub 2019 Feb 20.

Electronic Health Record Adoption and Nurse Reports of Usability and Quality of Care: The Role of Work Environment.

Kutney-Lee A1,2, Sloane DM1, Bowles KH3, Burns LR4, Aiken LH1.

Author information

Abstract

BACKGROUND:

Despite evidence suggesting higher quality and safer care in hospitals with comprehensive electronic health record (EHR) systems, factors related to advanced system usability remain largely unknown, particularly among nurses. Little empirical research has examined sociotechnical factors, such as the work environment, that may shape the relationship between advanced EHR adoption and quality of care.

OBJECTIVE:

The objective of this study was to examine the independent and joint effects of comprehensive EHR adoption and the hospital work environment on nurse reports of EHR usability and nurse-reported quality of care and safety.

METHODS:

This study was a secondary analysis of nurse and hospital survey data. Unadjusted and adjusted logistic regression models were used to assess the relationship between EHR adoption level, work environment, and a set of EHR usability and quality/safety outcomes. The sample included 12,377 nurses working in 353 hospitals.

RESULTS:

In fully adjusted models, comprehensive EHR adoption was associated with lower odds of nurses reporting poor usability outcomes, such as dissatisfaction with the system (odds ratio [OR]: 0.75; 95% confidence interval [CI]: 0.61-0.92). The work environment was associated with all usability outcomes with nurses in better environments being less likely to report negatively. Comprehensive EHRs (OR: 0.83; 95% CI: 0.71-0.96) and better work environments (OR: 0.47; 95% CI: 0.42-0.52) were associated with lower odds of nurses reporting fair/poor quality of care, while poor patient safety grade was associated with the work environment (OR: 0.50; 95% CI: 0.46-0.54), but not EHR adoption level.

CONCLUSION:

Our findings suggest that adoption of a comprehensive EHR is associated with more positive usability ratings and higher quality of care. We also found that-independent of EHR adoption level-the hospital work environment plays a significant role in how nurses evaluate EHR usability and whether EHRs have their intended effects on improving quality and safety of care.

Georg Thieme Verlag KG Stuttgart · New York.