Healthcare professionals are spending an average of 13.5 hours per week adding to, or creating, clinical documentation, a 25% increase in the last seven years, according to a new research report from Nuance and independent research consultancy, Ignetica.
The report is based on an extensive survey of 966 NHS healthcare professionals from four acute trusts and one mental health and community trust.
It gleans insights around the burden doctors, nurses, and allied health professionals, face in their day-to-day roles when it comes to producing accurate and timely clinical documentation.
If nothing changes, we are likely to see many healthcare staff suffering from burnout, which can have serious repercussions for the entire population
And it follows a 2015 report revealing that, although so much has happened in healthcare over the last seven years – from the introduction of new digital tools to a global pandemic – many of the documentation challenges clinicians face have remained the same or worsened.
In fact, the report found that the value of time for a consultant doctor searching for missing information and generating clinical documentation is circa £57,000 per doctor, per year.
The study discovered that the average time spent creating or adding to clinical documentation per week (13.5 hours) is more than a third of the average clinician’s working hours (37.7). It is also 2.7 hours more than in 2015.
Consultant nurses (16.5 hours) and consultant doctors (15.1 hours) are spending the longest on it.
The report cites increasing demand for healthcare services due to the pandemic as one reason for the increase in time spent on clinical documentation.
Higher patient numbers and a backlog of appointments is also adding to the challenge.
Moving away from pen and paper
However, it is particularly concerning to see that so much of this documentation is completed by clinicians outside of their working hours.
Healthcare professionals report spending an average of 3.16 hours per week adding to clinical documentation in their personal time – with consultant doctors reporting an average of 4.72 hours.
And less than half (40%) of respondents cited pen and paper as a main documentation format.
This is a positive development since the 2015 study, when 80-90% of clinicians relied on this modality.
This switch has brought a reduction in narrative content (from 69% of time to 42%) in clinical documentation for both inpatients and outpatients.
And, as more clinicians shift to using the EPR to complete their documentation, notes are becoming more structured within teams.
But, despite the switch from pen and paper to digital platforms like the EPR, there has not been a significant increase in documentation accuracy. In fact, in 25% of instances, clinicians report the information they need isn’t available in the records at the right time.
The number one cause for this is unclear and incomplete information in the clinical notes/records (36%).
A waiting game
Clinicians also report a significant increase in time waiting for diagnostics and investigation results (23%) and, in some instances, uncertainty in what diagnostics have been requested (19%).
As workloads continue to grow and healthcare organisations are forced to operate with more-limited resources, we are at risk of placing one of our most-precious institutions under even more avoidable pressure
These challenges add to the time clinicians need to spend wrestling with documentation throughout the day. In fact, despite an increase in digitisation, clinicians are still spending an hour a day looking for missing information.
“Despite the many technological advancements that have taken place in healthcare over the last seven years, the burden of clinical documentation remains,” said Dr Simon Wallace, chief clinical information officer at Nuance.
“As workloads continue to grow and healthcare organisations are forced to operate with more-limited resources, we are at risk of placing one of our most-precious institutions under even more avoidable pressure.
“If nothing changes, we are likely to see many healthcare staff suffering from burnout, which can have serious repercussions for the entire population.”
He added: “Every hour a clinician spends on creating or locating clinical documentation is one less hour spent on patient care.
“To enable them to get back to doing what they trained for, we must find new ways to help ease the growing burden of administrative responsibilities.”