'Alert fatigue and clinical burnout are a very real phenomenon'

In a recent virtual panel hosted by HIMSS in collaboration with Elsevier, key discussions, lead by industry experts, highlighted the importance of integrating the latest information, guidelines and care protocols at the point of care during a health crisis. Interesting insights were shared by the speakers outlining how and why the consistent adoption of evidence-based practices should become a new standard going forward.

During the webinar discussions, panellist, Dr Abdul Hameed Chagla, the director corporate hospital affairs & quality assurance, Doctor Sulaiman Al Habib Medical Group in the Kingdom of Saudi Arabia said: “We overrun our clinicians unintentionally and sometimes with information that may not be of use. If a physician receives many alerts that are not relevant, there is a chance of one relevant and important alert being ignored.

 “Alert fatigue and clinical burnout are a very real phenomena for healthcare teams, especially with the COVID-19 crisis,” Dr Chagla emphasised.

His organisation worked with Elsevier to implement a unique ‘traffic light system’ helping nurses and doctors prioritise key information, and effectively minimise alert fatigue and even burnout.

“We have created a system that is effective and easy to use for physicians. Any ‘need to know’ information – i.e. the information that can affect patient safety – is marked in red for importance, ‘useful’ information is in orange, and ‘just for information’ alerts are green. Ensuring clinicians know when they see a red flag, there is relevant information regarding clinical safety, which is not to be ignored; so they know they’ll need to look at it when they can,” said Dr Chagla.

Keeping track with an evolving situation

Dr Noor Majed al Mehiri, a family physician and the head of medical services for the Ministry of Health and Prevention in the UAE, shared similar experiences.

“The sheer volume of information that is being generated and the fact that it is changing very rapidly makes it a challenge for clinicians to digest. We needed to make sure that the processes we put in place, in terms of information management, were practical and efficient for our physicians and nurses,” she said.

“We implemented clinical decision tools and care pathways that would help our physicians so they have those protocols in hand, they can visualise them within their system and it is easy for them to see the evidence updates within the system.”

“We also collaborated with Elsevier to review the Order Sets and Care Plans and to localise them to fit our needs. This has enabled our physicians to see the latest evidence within the EMR, which can be incorporated into practice at the point of care.”

Robert Nieves, VP of Health Informatics at Elsevier confirmed nurses have been overwhelmed with information right from the beginning of the pandemic.

“The need for the right amount of information, at the right time, from trusted sources was something that we saw over and over again,” said Nieves, a registered nurse himself. “And we’ve seen that not only in Saudi Arabia and the UAE, but actually continuing on as the first wave encircled the globe.”

The real challenge is maintained and updated content

The panellists emphasised that, where information has been too sparse, or unreliable – and in too great a volume – it can hinder, rather than help an already overstretched healthcare team.

“The content that’s needed for the workflow is what’s generally missing from organisations,” said Elsevier’s Nieves. “So, when designing systems, the real challenge is making sure that you have content that’s maintained and updated readily and quickly within the workflows, together at the right time, right place and in the right context.”

“We have to think holistically – not only of physician workflow, nursing workflow and the allied health workflow, but also patient education and patient needs, as well as that of the caregivers. All these elements have to line up and this will lead to an efficient system.”

While the information challenge during the COVID-19 pandemic is huge, Dr Chagla also sees opportunity to get prepared now for future crises.

“Necessity being, of course, the mother of invention, the pandemic has been a catalyst for a much-needed transformation within our industry,” said Dr Chagla. “It has allowed us to grow as an industry. It has made us think outside the box on different things and as we go on, we learn, and we will improve.”

Elsevier has made available all of its most relevant, evidence-based knowledge resources to support the healthcare community in containing and managing the COVID-19 pandemic. Access to Elsevier’s COVID-19 Healthcare Hub is free and can be found here. 

Click here to view the virtual panel discussion.

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