Reducing Administrative Burnout through Patient Centred Care
The Shuswap Cardiac Society has been awarded the Healthcare Unburdened Grant through the Canadian Medical Association, MD Financial, and Scotiabank. The overarching goal of the grant program is to reduce administrative related burnout in physicians. Administrative work takes up ~45% of physicians time, which is time taken away from being with patients. The administrative load facing physicians is one of the key risk factors in physician burnout. Evidently, there is a critical and urgent need to reduce administrative burden among health care practitioners. Through support from the CMA, MD Financial, and Scotiabank, the Shuswap Cardiac Society aims to do this while focusing on patient centred care.
As a practicing internist, Dr. Laurie Main has seen the desire patients have to be involved in their health care journeys. At the Shuswap Cardiac Society, we firmly believe that patients should be considered equal partners in creating their healthcare plan. Unfortunately, many physician offices are currently setup in a way that reinforce power dynamics that leave patients feeling like outsiders in their own health care plans. That’s why our initiative puts the patient at the centre of their health care by restructuring both the appointment format, so that the physician can focus on the patient, as well as the office layout to have patients sit as equal partners in discussions surrounding their health.
“In launching our initiative, we’ve embarked on a mission not just to lift the weight of administrative tasks from the shoulders of Canada’s physicians but to restore the heart of healthcare—uninterrupted, high-quality, compassionate patient care. This grant isn’t just an incredible opportunity for us; it’s a promise to every patient that their well-being is our utmost priority.”
Office Redesign
The current way that many medical offices are setup have physicians or health care providers and patients on opposing sides of a desk, where patients are unable to see their medical records or diagnostic results. We have removed this physical barrier that contributes to inequitable power dynamics and instead sit together with patients at a round table to foster a collaborative approach. This design also intentionally invites family members or other patient advocates to be a part of the meeting and a part of the decision-making process in the patients’ health care path. Instead of a physician sitting behind a computer looking privately at the medical records, the patients results and medical history will be projected on a wall in the office so that all members of the health care team, including the patient and their advocates, can see during relevant parts of the appointment. A medical office assistant will also be present, taking notes that the patient will be able to take with them at the end of the appointment to ensure they feel well informed about all aspects of the appointment. The medical office assistant will also writeup any requisitions or referrals during the meeting to expedite to ensure timely care to the patient.
Artificial Intelligence (AI) Scribing
Electronic health records were designed to increase efficiency in administrative tasks, reduce error, and increase transparency with patients (Shultz et al., 2014). Unfortunately, many patients and physicians are dissatisfied with their use in patient appointments, finding that electronic health record’s divide physicians’ attention between the computer and the patient (Shultz et al., 2014; Mishra et al., 2018).
By using an artificial intelligence (AI) scribe the physician will be able to be fully present and engaged with the patient, allowing them to provide higher quality care. Having the AI scribe will minimize distractions, while the medical office assistant will monitor the AI scribe to ensure that all records are accurate and complete. Together, this will work to meet the grant’s goal of reducing administrative burden, while improving patient centred care.
Project Scope
Currently, this exciting project is underway at Dr. Laurie and Christopher Main’s internist clinic here in Salmon Arm. Over the next 2 years, we aim to expand the project to other practices here in Salmon Arm and across the Interior Health region to provide deliver high quality, patient centred care in our communities. Following the successful uptake in these clinics, we envision this project being adopted in clinics across British Columbia and, ideally, Canada.