Electronic Health Record Fatigue in Patient Care at Public Hospitals in Northern California

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This mixed methods study examined provider perceptions of electronic health record (EHR) fatigue and burnout and their effects on care efficiency and effectiveness at public hospitals in northern California. The study identified factors that affect EHR user interface experience and patient safety. The research problem is whether EHR fatigue is driving burnout among providers and (b) burnout affects patient care. The study employed a convergent parallel design, which combined interviews of medical providers and the Q-methodology. The study found that EHR utilization is associated with fatigue caused by increased work burden, especially in fast-paced clinical environments. Providers perceive the association of EHR to efficiency as positive. EHR user interface complexity, conducive organizational culture, and organizational support are factors contributing to the EHR user experience. EHR is associated with higher patient safety and fewer sentinel events. The study’s findings provide further empirical affirmation of the predictions of the job demands–resources theory and Freudenberger’s theory of burnout and highlight the theoretical importance of the effectiveness-efficiency theoretical paradigm of public administration, including the legacy of scientific management. The findings have implications for the management of public health care organizations and for public policy and administration.
A dissertation submitted in partial fulfillment of the requirements for the degree Doctor of Public Administration
Public Administration, Public Policy, Information Technology