In April 2023, the American Academy of Nursing (Academy) hosted a policy dialogue on “More Than Documentation Burden Creating Burnout: What Systems Must do to Achieve Safe, Efficient Patient Care Using Technology.” The Academy’s Informatics & Technology Expert Panel, in collaboration with the Expert Panels on Acute & Critical Care, Quality Health Care, Bioethics, and Building Health Care System Excellence, convened this dialogue to discuss policy issues associated with the documentation burden for nurses. This policy dialogue provided participants the opportunity to hear from leading experts in health informatics and explore the underlying issues surrounding burnout, distress, and documentation burden, specifically relating to how technological stress impacts clinicians. Participants in this dialogue explored the critical policy implications related to these issues and how the profession can address them.

• Critically Reflect on Documentation Requirements 
  The ever-increasing addition of tasks for nurses to document through the EHR contributes to high levels of stress and burnout. Critical reflection on the documentation needs and the delegation of that responsibility can mitigate nurse burnout and improve the quality of care given. 
  
• Amplify Nursing’s Expertise in Decision-Making on Documentation
  The COVID-19 pandemic highlighted nurses' integral role in the functionality and quality of health care. However, nurses are still rarely called on for their expertise during their organization’s decision-making process resulting in shifts to their workload without the opportunity to inform system change. Nursing’s expertise must be sought after as recommendations for documentation reforms are being made.
  
• Encourage Innovation and Collaboration 
  Tackling health care providers’ burnout from the documentation burden requires systematic changes to the delivery of care. Innovation, such as through AI, and human interface must be prioritized for developing ethical and effective solutions both at an organizational and institutional level. 
  
• Institutionalize Well-Being as a Long-Term Goal for Health Care Professionals
  Burnout mitigation is not a one-size-fits-all all approach, and there is a need for precision in achieving wellness for patients while also supporting health care providers’ health and well-being. By creating standards institutionally, well-being can become a long-term, sustainable goal. 

Guest Panelists

• Vicky L. Tiase, PhD, RN-BC, FAMIA, FNAP, FAAN, Strategic Director for Digital Health and Assistant Professor of Biomedical Informatics, University of Utah
• Steph Hoelscher, DNP, RN-BC, CPHIMS, CHISP, FHIMSS, Associate Professor of Graduate Informatics
  Texas Tech University Health Sciences Center
• Jess Dillard-Wright, PhD, MA, RN, CNM, Assistant Professor, University of Massachusetts Amherst Elaine Marieb College of Nursing
• Allison A. Norful, PhD, RN, ANP-BC, FAAN, Assistant Professor, Columbia University School of Nursing
• Mari Tietze, PhD, RN-BC, FHIMSS, FAAN, Myrna R. Pickard Endowed Professor, University of Texas at Arlington College of Nursing and Health Innovation
  

Planning Committee

• Susan McBride, PHD, RN-BC, CPHIMS, FAAN, Professor, Associate Dean of Research, The University of Texas at Tyler
• Mari Tietze, PhD, RN-BC, FHIMSS, FAAN, Myrna R. Pickard Endowed Professor, University of Texas at Arlington College of Nursing and Health Innovation
• Tracy Gosselin, PhD, RN, AOCN, NEA-BC, FAAN, Senior Vice President and Chief Nursing Executive; Enid A. Haupt Chair in Nursing, Memorial Sloan Kettering Cancer Center
• Vicky L. Tiase, PhD, RN-BC, FAMIA, FNAP, FAAN, Strategic Director for Digital Health and Assistant Professor of Biomedical Informatics, University of Utah
• Jane Carrington, PhD, RN, FAMIA, FAAN, Associate Professor, University of Florida
• Ronda Hughes, PhD, MHS, RN, FAAN, Mentor, Doctorate of Health Care Administration, Capella University
• Lillee Smith Gelinas, DNP, RN, CPPS, FAAN, Editor-in-Chief, American Nurse Journal
• Cynda Hylton Rushton, PhD, RN, FAAN, Anne and George Bunting Professor of Clinical Ethics, Johns Hopkins University
• Vallire Hooper, PhD, RN, CPAN, FASPAN, FAAN, Senior Nurse Scientist, Ascension
  
• Steph Hoelscher, DNP, RN-BC, CPHIMS, CHISP, FHIMSS, Associate Professor of Graduate Informatics
  Texas Tech University Health Sciences Center
• Jess Dillard-Wright, PhD, MA, RN, CNM, Assistant Professor, University of Massachusetts Amherst Elaine Marieb College of Nursing
• Allison A. Norful, PhD, RN, ANP-BC, FAAN, Assistant Professor, Columbia University School of Nursing
• Rae Walker, PhD, RN, FAAN, Associate Professor and PhD Program Director, University of Massachusetts Amherst
• Rebecca Freeman, PhD, RN, FAAN, Vice President for Health Informatics, The University of Vermont Health Network

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