Cloud-based tools are "essential" to tackle clinical burnout
For Allison Morin, MSN,RN-BC, the term "nursing burnout" has become all too familiar over the past year. With a year of COVID-19 plaguing hospital systems worldwide, increasing numbers of nurses and doctors are reporting clinical burnout - a problem that was already on the rise before the pandemic.
Before 2020 around 40% of nurses reported feeling unengaged in their organisation and experiencing burnout, but this has escalated dramatically. The British Medical Association has says the've had an increase of 47.8% in the numbers of healthcare workers calling their counselling helpline with anxiety, stress and other mental health conditions due to their job.
Morin believes that this will have long term implications. "I would expect symptoms of burnout to continue even after COVID-19 is largely under control – there are several other factors that perpetuate it, from having to balance multiple, poorly communicating technology systems to alarm and alert fatigue."
Women, who make up over 70% of the frontline workforce worldwide, have been hit hardest. "Women also tend to carry additional stress outside of the profession" Morin says. "It is intrinsic to who we are and why we went into healthcare in the first place – to be caregivers. We balance patient care with childcare, with being a supportive spouse or partner, with caring for elderly parents and extended family, and more.
"This balance isn’t necessarily gender specific – all clinicians are balancing the stresses of personal and professional life. So, when it comes to adequately addressing burnout, healthcare organisations need to support the entire person, and this means providing resources that promote wellness but also making organisational changes that address drivers of burnout in the workplace.
"Employee assistance programs are helpful but alone they are not an adequate response to burnout" Morin adds. "Healthcare leaders need to recognise the fact that burnout is driven by environmental factors at the workplace and an adequate response involves addressing those factors."
Technologies that increase the efficiency of clinical communication are a solution. "It shouldn’t be complicated for clinicians to communicate when literally any miscommunication, or delay in care due to poor communication, puts human life at risk" Morin says.
"A great example of this during the pandemic is that at the beginning, we would hear story after story about patients arriving with little respiratory distress to suddenly require immediate care, even intubation. Adequately supporting these patients required clinicians to quickly reach the team members that could assist with intubation, and for those team members to instantly respond.
"Any delay in that communication put patients at risk, and that is unacceptable. Tools that are helping to bridge this communication gap are a tremendous help to nurses, physicians, and the patient populations we serve."
The pandemic has highlighted weaknesses in healthcare settings, particularly around communication. "Hospital systems are now largely having to balance the continued fight against COVID-19 with how to address those areas of weakness with strained resources" Morin says.
"SaaS and cloud-based tools are essential to this effort. They are far easier to implement than traditional on-premise technology, and often require far less maintenance, fewer resources, and even reduce total project time compared to typical on-premise solutions. They are also typically very intuitive, which increases adoption and utilization.
"In this way, SaaS and cloud-based tools somewhat embody the “do more with less” trajectory that healthcare has been on for a while. They empower hospital systems to simplify their IT infrastructures while providing powerful collaboration resources to clinical and non-clinical staff."
Now that vaccination programmes are being rolled out, there is some cause for positivity among clinicians, but Morin stresses that vaccines won't fix everything. "COVID-19 has been a rollercoaster. There were moments at the beginning where clinical staff were furloughed, for example, due to eliminating elective procedures.
"When those restrictions were lifted, many clinicians returned to work to encounter peak after peak of COVID-19 – so they were balancing everyday patient care, with caring for complex COVID-19 patients, with elective procedures. This workload, combined with traumatic experiences of having to help family members say goodbye to loved ones from a distance…I would anticipate clinicians will be skeptical, and if there is an opportunity to breathe, many will need to use that moment of breath to recognise and heal from the traumatic experiences they encountered during this pandemic.
"There’s a reason we clapped for these people as they walked into work every day – they’ve experienced situations we on the outside can’t quite comprehend. Vaccines are, I am sure, a source of hope and happiness for clinicians but they aren’t the entire solution. We have continued work to do to support our healthcare providers."
As a board-certified clinical informatics nurse with more than 15 years of direct patient care experience, Alison Morin is a leader in strategic and operational nursing communication and technology-enabled care delivery. Morin has extensive experience with adopting process change to maximize patient safety, quality of care, and operational efficiency. She has led the development, deployment, re-engineering, optimization, and integration of clinical information systems, and is well-versed in ensuring continuous clinical regulatory readiness. Morin leads nurse communication strategy, implementation and customer success for Halo Health, serving as Chair of the Halo Health Nursing Advisory Council and Co-Chair with Angel Mena of the Halo Health Clinical Committee.
How UiPath robots are helping with the NHS backlog
The COVID-19 pandemic has caused many hospitals to have logistical nightmares, as backlogs of surgeries built up as a result of cancellations. The BMJ has estimated it will take the UK's National Health Service (NHS) a year and a half to recover.
However software robots can help, by automating computer-based processes such as replenishing inventory, managing patient bookings, and digitising patient files. Mark O’Connor, Public Sector Director for Ireland at UiPath, tells us how they deployed robots at Mater Hospital in Dublin, saving clinicians valuable time.
When Did Mater Hospital implement the software robots - was it specifically to address the challenges of the pandemic?
The need for automation at Mater Hospital pre-existed the pandemic but it was the onset of COVID-19 that got the team to turn to the technology and start introducing software robots into the workflow of doctors and nurses.
The pandemic placed an increased administrative strain on the Infection Prevention and Control (IPC) department at Mater Hospital in Dublin. To combat the problem and ensure that nurses could spend more time with their patients and less time on admin, the IPC deployed its first software robots in March 2020.
The IPC at Mater plans to continue using robots to manage data around drug resistant microbes such as MRSA once the COVID-19 crisis subsides.
What tasks do they perform?
In the IPC at Mater Hospital, software robots have taken the task of reporting COVID-19 test results. Pre-automation, the process created during the 2003 SARS outbreak required a clinician to log into the laboratory system, extract a disease code and then manually enter the results into a data platform. This was hugely time consuming, taking up to three hours of a nurse’s day.
UiPath software robots are now responsible for this task. They process the data in a fraction of the time, distributing patient results in minutes and consequently freeing up to 18 hours of each IPC nurse’s time each week, and up to 936 hours over the course of a year. As a result, the healthcare professionals can spend more time caring for their patients and less time on repetitive tasks and admin work.
Is there any possibility of error with software robots, compared to humans?
By nature, humans are prone to make mistakes, especially when working under pressure, under strict deadlines and while handling a large volume of data while performing repetitive tasks.
Once taught the process, software robots, on the other hand, will follow the same steps every time without the risk of the inevitable human error. Simply speaking, robots can perform data-intensive tasks more quickly and accurately than humans can.
Which members of staff benefit the most, and what can they do with the time saved?
In the case of Mater Hospital, the IPC unit has adopted a robot for every nurse approach. This means that every nurse in the department has access to a robot to help reduce the burden of their admin work. Rather than spending time entering test results, they can focus on the work that requires their human ingenuity, empathy and skill – taking care of their patients.
In other sectors, the story is no different. Every job will have some repetitive nature to it. Whether that be a finance department processing thousands of invoices a day or simply having to send one daily email. If a task is repetitive and data-intensive, the chances are that a software robot can help. Just like with the nurses in the IPC, these employees can then focus on handling exceptions and on work that requires decision making or creativity - the work that people enjoy doing.
How can software robots most benefit healthcare providers both during a pandemic and beyond?
When the COVID-19 outbreak hit, software robots were deployed to lessen the administrative strain healthcare professionals were facing and give them more time to care for an increased number of patients. With hospitals around the world at capacity, every moment with a patient counted.
Now, the NHS and other healthcare providers face a huge backlog of routine surgeries and procedures following cancellations during the pandemic. In the UK alone, 5 million people are waiting for treatment and it’s estimated that this could cause 6,400 excess deaths by the end of next year if the problem isn’t rectified.
Many healthcare organisations have now acquired the skills needed to deploy automation, therefore it will be easier for them to build more robots to respond to the backlog going forwards. Software robots that had been processing registrations at COVID test sites, for example, could now be taught how to schedule procedures, process patient details or even manage procurement and recruitment to help streamline the processes associated with the backlog. The possibilities are vast.
The technology, however, should not be considered a short-term, tactical and reactive solution that can be deployed in times of crisis. Automation has the power to solve systematic problems that healthcare providers face year-round. Hospital managers should consider the wider challenge of dealing with endless repetitive work that saps the energy of professionals and turns attention away from patient care and discuss how investing in a long-term automation project could help alleviate these issues.
How widely adopted is this technology in healthcare at the moment?
Automation was being used in healthcare around the world before the pandemic, but the COVID-19 outbreak has certainly accelerated the trend.
Automation’s reach is wide. From the NHS Shared Business Service in the UK to the Cleveland Clinic in the US and healthcare organisations in the likes of Norway, India and Canada, we see a huge range of healthcare providers deploying automation technology.
Many healthcare providers, however, are still in the early stages of their journeys or are just discovering automation’s potential because of the pandemic. I expect to see the deployment of software robots in healthcare grow over the coming years as its benefits continue to be realised globally.
How do you see this technology evolving in the future?
If one thing is certain, it’s that the technology will continue to evolve and grow over time – and I believe there will come a point in time when all processes that can be automated, will be automated. This is known as the fully automated enterprise.
By joining all automation projects into one enterprise-wide effort, the healthcare industry can tap into the full benefits of the technology. This will involve software robots becoming increasingly intelligent in order to reach and improve more processes. Integrating the capabilities of Artificial Intelligence and Machine Learning into automation, for example, will allow providers to reach non-rule-based processes too.
We are already seeing steps towards this being taken by NHS Shared Business Service, for example. The organisation, which provides non-clinical services to around two-thirds of all NHS provider trusts and every clinical commissioning organisation in the UK, is working to create an entire eco-system of robots. It believes that no automation should be looked at in isolation, but rather the technology should stretch across departments and functions. As such, inefficiencies in the care pathway can be significantly reduced, saving healthcare providers a substantial amount of time and money.