Between January 16, 2016 – July 21, 2017, a multidisciplinary process improvement team used Sprints to enhance EHR performance for clinicians at six UC Health Clinics. Sprints involve training clinicians on current EHR functionality, redesigning clinic workflow, and adding new EHR features.
University of Colorado Health (UCHealth)
- Academic Medical Center
- Electronic medical record
Team Members Involved
- Clinical Informatics Specialist
- Data Analyst
- Innovators at UCHealth used Agile methodology, which focuses on end-users needs and quick, incremental changes, to develop Sprints to identify problems with the EHR and make improvements. This EHR optimization process was conducted at 6 clinics with 220 clinicians. The 11-person team (including informaticists and EHR trainers) leading the Sprints ran focus groups and collected surveys from providers before and after the Sprints to assess efficacy. During the intervention, the team provided hundreds of one-to-one training sessions on specific EHR features and customized add-on tools to address clinicians’ evaluations of EHR gaps.
- Preparatory meetings with providers were 90, 60, and 30 days before each Sprint.
- Providers had protected time during each Sprint (at least 4 hours) so they could participate in a kickoff meeting, have at least three one-to-one training sessions, and have a two hour wrap-up meeting.
- Participating clinicians responded positively to EHR improvements, expressing a 27 point increase in Net Promoter Score for UC Health’s Epic system [the Net Promoter Score ranges from −100 (worst) to +100 (best)].
- Further, clinicians’ attitudes improved across multiple scales as many ultimately viewed the EHR as an essential component. For example, EHR-induced burnout improved, decreasing 5 percentage points among responding clinicians compared to a pre-test baseline. However, the innovators report the improvement was not statistically significant. Overall, the intervention’s selected methodology was supported by measuring a high Net Promoter Score of +52 for the program.
- The project timeline did not allow the innovators to provide continued EHR support following the program. To avoid introducing recall bias, innovators needed to promptly administer the post-survey just two weeks after the program.
- Innovators followed Agile methodology which meant that new variables were constantly being developed and assessed during the intervention. These variables often lacked baselines or sufficient sample size making it challenging to obtain statistically significant results.
Sieja, A., Markley, K., Pell, J., Gonzalez, C., Redig, B., Kneeland, P., & Lin, C. T. (2019, May). Optimization sprints: improving clinician satisfaction and teamwork by rapidly reducing electronic health record burden. In Mayo Clinic Proceedings (Vol. 94, No. 5, pp. 793-802). Elsevier.