How HM’s First KLAS Survey is Making a Difference
It’s been a year since Houston Methodist participated in its first KLAS Arch Collaborative survey, giving our providers, nurses and other clinicians the opportunity to share their valuable feedback on Epic — what’s working, what’s not. After receiving the results, HM leaders began evaluating what you had to say about your experience, including Epic training and support, as well as overall IT support, and developing a strategic plan to make improvements.
Now, we’re gearing up for our next KLAS survey, planned for early next year. Let’s look at why this survey is so important and how feedback from our first survey is making an impact.
What is the KLAS survey? Why is it important?
KLAS Research uses standardized surveys to gather feedback from clinicians on the technology they’re using to care for patients and the support they receive to use this technology successfully. KLAS has partnered with almost 300 health care systems and surveyed over 340,000 clinicians to gauge their electronic health record (EHR) experiences and uncover what factors contribute to some clinicians having a better experience than others. KLAS compiles this data to create benchmarks, so health care organizations, like HM, can compare their results with other organizations and identify opportunities for improvement.
“We have significant data around our clinicians’ EHR use, such as how much time they’re spending in certain activities or after hours, but the KLAS survey gives us insight into their complete experiences,” said Dr. Jordan Dale, HM chief medical information officer. “Measuring and benchmarking these experiences helps us to better understand how our clinicians feel about using Epic and the support they receive from IT. These findings are driving systemwide initiatives to make improvements, help reduce burnout and give our clinicians more time with their patients.”
Real results, driving real change
While the KLAS survey found that many HM clinicians are highly satisfied with Epic and value it as an important tool in patient care, it also identified opportunities to improve training and support and incorporate our clinicians’ voices into future Epic features and changes. There were also commonalities discovered among HM clinicians with higher Epic satisfaction rates that contributed to a better experience, including a strong Epic proficiency.
“Our KLAS survey results have emphasized how important Epic efficiency training is in driving stronger Epic proficiency and a better experience for our providers and nurses,” said Lisa Stephenson, HM chief nursing informatics officer. “Ensuring that our clinicians are Epic proficient helps reduce the time they spend in the chart, so they have more time with patients. It also ensures they’re able to find the information they need, when they need it, to provide quality patient care.”
Survey results specifically identified opportunities for better Epic training for nurses.
“To support our nurses, one step we’ve taken is to offer new, hands-on supplemental training to help newly hired inpatient nurses become more comfortable using Epic,” said Stephenson. “We want to ensure our new nurses have the skills, knowledge and tools they need to succeed. For our veteran nurses, we have a series of efficiency training courses available in LMS, so they can pick the content they want to review, when it’s convenient for them.”
To help providers improve their Epic skills, HM held its first provider Epic Efficiency Bootcamp in February. This four-day event offered both inpatient- and outpatient-focused sessions that included Epic tips, as well as application and personalization assistance with an Epic trainer.
“Our first Epic Efficiency Bootcamp had a great turnout,” said Dr. Dale. “Some providers attended multiple days and every time I attended a session, if I didn’t learn something myself, I heard the gasps and awe from attendees learning a simple new trick.”
“The KLAS survey also connected Epic personalization to higher satisfaction rates,” said Dr. Dale. “Offering application and personalization assistance at these sessions was another big step to improve our providers’ experience.”
Epic and KLAS have partnered to recognize that strong, ongoing EHR and refresher training significantly improves the EHR experience.
“We now suggest at least 3-5 hours of refresher training per year,” said Dr. Dale. “It ensures clinicians are leveraging the most up-to-date, impactful features for their workflows. This could be reading our monthly newsletters and incorporating new tips and tricks. Providers can schedule a 30 or 60 minute session with one of our physician support coordinators or Epic Thrive team members, or attend Epic’s Efficiency Hours and SmartUser training.”
Fewer disruptions, more time with patients
HM’s KLAS survey results also found that clinicians felt that Epic workflows could be more efficient.
“We’re always looking for ways technology can help automate certain tasks and decrease unnecessary burdens that can sometimes pull clinicians away from direct patient care,” said Stephenson. “The survey helped direct us to specific parts of documentation that nurses felt were the most inefficient — flowsheets and care plans. As a result, we’ve been working with clinical experts to find ways to improve flowsheet documentation. Examples of the resulting changes include the addition of flowsheet macros and a new shift navigator. We’re also currently reviewing our existing care plan content and process for opportunities to improve.”
Another key initiative sparked by KLAS survey feedback has decreased the number of BestPractice Advisories (BPAs) and disruptive workflows. BPAs are pop-up reminders, triggered in different clinical workflows as important reminders for things like orders and medications. While they’re often deemed necessary, they can sometimes be disruptive, inadvertently contributing to “information overload” when clinicians are trying to complete tasks in Epic, essential to patient care.
“After hearing KLAS survey feedback, we’ve been actively working to decrease the number of BPAs and disruptive workflows our clinicians have been experiencing,” said Dr. Dale. “We’re collaborating with various stakeholders and have made significant progress in decreasing the number of interruptive BPAs that disrupt our clinicians’ workflows and time with their patients. So far, we’ve retired over 100 BPAs and have decreased the number of passive and interruptive BPAs by over 50%.”
Nursing BPAs are also being reviewed. This will ensure that the BPAs nurses see are clear, concise and actionable.
“We’ve retired 22% or 111 BPAs and 51% have been updated,” said Stephenson. “We’re working on more reductions in the future.”
Improved performance, better support
KLAS survey feedback is also driving initiatives for better IT support and improved Epic system performance.
“We’ve been actively working to drive initiatives that will help improve Epic system performance and reliability,” said Dr. Dale. “We’re also working to ensure that our clinicians are able to get the IT support they need, when they need it, so they can focus on patient care.”
Last week, HM moved Epic to the cloud — a cluster of remote servers used to save data, accessible anytime, anywhere via the internet. Instead of HM storing our own Epic data, it’s now hosted on Epic Corp’s servers. This will provide better reliability with fewer downtimes, among many other benefits.
Next year, HM will transition to Epic Hyperdrive — a special internet browser, like Google Chrome or Microsoft Edge — used to access a web-based version of Epic, instead of accessing Epic through an application installed on a workstation. More information will be provided closer to the launch date, but this change will provide several new features, including better Epic performance with shorter downtimes.
To make a difference, participation is key
The KLAS survey gives HM leaders insight into our clinicians’ overall Epic experience, identifying ways we can improve that experience and give them more time with their patients. However, the only way we can improve satisfaction rates is for every clinician to participate in these surveys.
“Participating in the KLAS survey is key to ensuring our clinicians’ voices are heard in IT,” said Stephenson. “We want them to know that we take their feedback seriously, and it’s making a difference. This is why it’s important that all HM providers and nurses take the time to complete these surveys. We want to make sure that all clinical roles, across all specialties are well represented, driving better patient care.”
The next KLAS Arch Collaborative survey is planned for early 2024. Be on the lookout for more information in IT Matters, Digital Digest and Physician Connect, so you can provide your valuable feedback and make a difference.