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Published on: February 19, 2021
Harnessing institutional knowledge: mixed methods evaluation of peer coaching in a multi-site EHR transition
Julian Brunner1,2, Ryan Sterling3, Ekaterina Cole4
1Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA 91343, United States.
Summary
Peer coaching through the National EHRM Supplemental Staffing Unit (NESSU) effectively supported clinicians during an electronic health record (EHR) transition. This program reduced clinician burnout and demonstrated the value of peer support in healthcare technology adoption.
Area of Science:
- Healthcare Management
- Health Informatics
- Clinical Support Systems
Background:
- Electronic Health Record (EHR) transitions present significant challenges for clinician preparedness and support.
- Health systems often struggle to effectively train and assist users during new EHR implementations.
- The U.S. Department of Veterans Affairs (VA) faced these challenges during its large-scale EHR transition.
Purpose of the Study:
- To evaluate the reach and perceived usefulness of the National EHRM Supplemental Staffing Unit (NESSU) peer coaching program.
- To assess the association between NESSU participation and key EHR user outcomes, including burnout, stress, and confidence.
- To characterize the mechanisms through which NESSU achieved its impacts during the VA's EHR transition.
Main Methods:
- A convergent mixed-methods design was employed, combining surveys and qualitative interviews.
- Surveys collected data from EHR users at a VA facility undergoing EHR implementation.
- Regression models analyzed the relationship between NESSU participation and user outcomes; thematic analysis explored qualitative feedback.
Main Results:
- 58.4% of surveyed EHR users received NESSU support, with 83.6% finding it helpful.
- NESSU participation was significantly associated with lower rates of clinician burnout (29% vs. 41%, P=0.016).
- No significant associations were found between NESSU participation and EHR-related stress or confidence; qualitative themes highlighted NESSU's role in education, responsive support, expert guidance, and interpersonal skills.
Conclusions:
- Peer coaching programs, like NESSU, can effectively address critical support needs during EHR transitions.
- Clinician-led peer coaching is a scalable solution that can enhance both the implementation of large-scale EHR systems and clinician well-being.
- The findings support the integration of peer coaching as a vital component in healthcare technology adoption strategies.
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