P0023 - Not Just Papercuts: Removing Unnecessary EHR Alert Saves Real Caregiver Time

Background: Our frontline caregivers expressed frustration at unhelpful EHR alerting. We identified a "missing weight and allergies" alert upon chart opening as the single most frequently fired alert in our EHR, and aimed to reduce its appearance, saving caregiver time. Intermountain Healthcare's Dosing Weight Team was assembled in 2019 to address many issues with EHR weight-based dosing and quickly identified this opportunity to reduce an unnecessary alert.

Methods: We identified key stakeholders and workflow processes that required this alert appearance and aggressively worked to reduce all other other appearances. Alert firing per month and balancing measures were calculated using Cerner's Lights On Network software. Comparison post interventions were made to baseline data from July 2019. Subjective feedback on the changes was obtained from physician and non-physician caregivers.

Results: The missing weight and allergies alert fired 268,455 times in the month of July 2019. We iteratively reduced this to 92,775 in August 2019 and to a minimum desired level of 6,464 times in November 2019, (97.6% absolute reduction). We calculated the time the software takes to fire the alert (1 second), and the time caregivers spend addressing the alert (3.5 seconds). Caregiver subjective feedback was uniformly positive. These 4.5 seconds per alert multiplied by the alerts reduced revealed a return of 327 hours per month total caregiver time that had been occupied by this alert. The financial impact of this time savings was $18,369/month based on weighted salary averages for caregivers seeing this alert.

Conclusion: Unnecessary alerts in the EHR are not only annoyances, but constitute real and calculable hits on efficiency and productivity. Unnecessary alert reduction can delight caregivers.