Date of Award
Spring 3-14-2025
Embargo Period
3-14-2028
Document Type
Dissertation
Degree Name
Doctor of Health Administration
Department
Health Administration
College
College of Health Professions
First Advisor
Abby Swanson Kazley
Second Advisor
Eva Karp
Third Advisor
Jennifer Ferrand
Abstract
This study investigates the clinical documentation burden experienced by healthcare providers, focusing on the usability, effort, and perceived value of clinical documentation tasks. The main theory explored in the study is the concept of intrinsic motivation and task value perception, which is linked to professional dissonance and burnout, providing a framework to understand the clinical documentation burden experienced by clinicians. It aims to understand the relationship between these factors and the clinician experience of burden with the goal of developing a comprehensive conceptual framework. To establish an understanding of clinical documentation burden, a scoping literature review was conducted using four electronic databases covering studies from 2014 to 2024. The review was guided by the PRISMA-ScR guidelines and utilized the Covidence software for systematic management. The review identified key factors contributing to documentation burden, including EHR usability issues, regulatory requirements, and payer-driven demands. The analysis discusses how perceived task value significantly influences the burden experienced by clinicians. A newly constructed questionnaire based on a scoping review of the literature was used, incorporating elements from established instruments. Data were collected from a cross-sectional, nonexperimental survey using a convenience sample of healthcare providers. Descriptive and exploratory factor analysis was performed to identify significant findings and develop the Clinical Documentation Burden Model. The analysis revealed three main factors underpinning clinical documentation burden: poor usability, perceived task value, and excessive mental exertion. These factors were significantly correlated with professional dissonance and burnout, underscoring the complex interplay between design challenges, task engagement, and cognitive load. The resulting theoretical model highlights the importance of aligning documentation tasks with provider values to mitigate burden. The study describes the critical impact of documentation burden on healthcare providers and suggests that consideration of psychological factors into documentation processes could alleviate operational strain and reduce professional dissonance and burnout. The developed model provides a framework for future interventions and calls for empirical studies to validate its applicability across diverse healthcare settings.
Recommended Citation
Doherty, Rhiannon, "A Theoretical Model of Clinical Documentation Burden: Exploratory Factor Analysis Investigating Usability, Effort, and Perceived Burden Among Healthcare Providers" (2025). MUSC Theses and Dissertations. 1036.
https://medica-musc.researchcommons.org/theses/1036
Rights
Copyright is held by the author. All rights reserved.
Included in
Health and Medical Administration Commons, Health Information Technology Commons, Psychological Phenomena and Processes Commons