The effects of automation of a patient-centric service in primary care on the work engagement and exhaustion of nurses

Abstract

Digitalising patient-centric services to address society’s challenges with an ageing population and healthcare provision is by many seen as important. Studying the effects of the digitalisation on the work engagement of the users of the new systems is vital in this context, especially since previous research has established that the work engagement at work in healthcare is problematic. Work engagement is defined as a positive, fulfilling, affective-motivational state of work related well being, as is closely connected to the experience of resources and demands in the work context. These resources can be for example digital support, experienced demands or empowerment whereas exhaustion is connected to work demand in a workplace. This study contributes to knowledge about the effects of digitalisation on work engagement and exhaustion in the context of patient-centred services and eHealth. Contextual interviews were conducted on site for 5 h with nurses using a new chat function and using telephone for medical advice to patients. Additionally, semi-structured interviews were conducted with all the nurses participating in this digitalisation project to gather more insights into their work engagement in the two work situations. Results were analysed in different themes of areas affected by the digitalisation in the two overarching themes: job demands and job resources. The results show that the change to a chat function when communicating with advice seekers had connection to work engagement in several ways. The nurses experienced less time pressure and emotional pressure, but also a loss of job control and feedback from colleagues working from home.

Understanding how the design and implementation of Online Consultations influence primary care outcomes: Systematic review of evidence with recommendations for designers, providers, and researchers

“…MCQs also asked questions about seemingly 'irrelevant' symptoms, which staff were responsible to assess and follow up, diverting attention away from the patient's primary concern (e.g. [45]). Due to their restrictive nature, patients regularly adapted their responses to MCQs to get the outcome they wanted, even when it was not the most appropriate use of resources.…”

Embedding and Integrating a Digital Patient Management Platform Into Everyday Primary Care Routines: Qualitative Case Study

“…The same digital platforms as studied in this paper have been studied in different primary care settings [7][8][9]. However, the findings show diverse results and have not explicitly focused on the normalization process.…”

“…This finding contrasts with the findings of Entezarjou et al [9], who indicated that the digital platform increased interdisciplinary communication and streamlined patient consultations. However, it is not clear whether the lack of feedback was because of the use of the digital platform or whether this was also common in the ordinary care routine before the implementation of the platform [7].…”

The Fear of Losing Control - What Prevents the Automation of Business Processes in Sensitive Areas

“…Not only since the permanent burden of the Covid 19 pandemic has professional nursing been characterized by increasing work pressure, work compression, and growing physical and psychological stress [1][2][3]. This is accompanied by an increasing investment backlog in digitization and technologization in the context of sensitive care processes [1,4,5].…”

“…However, there are numerous barriers, such as the lack of empowered staff, the lack of flexibility in volatile processes, or the lack of an infrastructural framework for implementing automation [2,5]. The scientific discourse describes that the possibility of self-service development of automation, preferably by the end-user, can allow to control the development costs and to deal more dynamically with changes in the overall structure and environment [13].…”