Table 1.

The Impact of Structural Capabilities on Clinician Job Outcomes

Electronic Health Records (EHRs)

• Provide a platform for care delivery, documentation, and information exchange through computerized systems for various clinical tasks and have been considered by The National Academy of Medicine as a key component of the professional practice environment.25   • While EHRs are critical to care delivery, their use has been associated with higher burnout,26 although some recent findings indicate these systems may help improve workflow and provider experience.27

Shared Communication Systems

• Shared system of communication are structures that organizations use to facilitate communication between healthcare providers or between providers and patients and are often integrated within the EHR.28   • Patients reported greater satisfaction with computerized notification systems,29 suggesting that these may reduce administrative burden and potentially improve provider working conditions without compromising patient satisfaction.

Care Reminders

• Care reminders are also often integrated within the EHR and aid providers in remembering patient care responsibilities (e.g., prompts, clinical decision support)30 and are associated with delivery of care31 and process adherence.30   • Little is known about how these reminders ultimately influence clinician job outcomes.

Community Health Referral Systems

• Community health referral systems connect patients, especially those with chronic conditions, to relevant community health resources.32   • Examples include senior support services, mental health and addiction services, and chronic disease prevention and management.   • Despite the important potential benefits of equipping providers to address social risk factors, it is unclear whether these systems impact provider job outcomes.

Disease Registries

• Disease registries are deployed in primary care settings to track and manage particular patient populations, health outcomes, care lapses, and set care management goals.33   • Disease registries are often used to manage patients with one or more chronic conditions and are helpful in centralizing efforts to gather, track, sort, and report data from multiple sources at the patient- and population-level in automated ways, helping providers identify gaps in care and make appropriate follow-ups.33

Care Management

• Care management involves the use of a dedicated clinician team (or a dedicated clinician) to help patients improve their functional health status, minimize the need for acute care services, and improve care engagement.34   • Primary care providers using care management teams report higher job satisfaction, retention,35 and lower stress levels.36,37

Performance Feedback

• Performance feedback is necessary for providers to improve care delivery and assess their performance across professional standards.38   • A lack of feedback on performance is associated with over a 2-fold increase in burnout among primary care workers.39   • Performance feedback may also help advance medical trainees through their residency and increase confidence in their performance.40   • These findings indicate that clinicians benefit from feedback and performance evaluations, enabling them to better achieve their professional goals.

After-Hours Care

• After-hours care is a measure of a facility’s extended practice hours, where regular ambulatory care services are available during evenings and weekends.41   • The infrastructure for after-hours care may provide greater staff coverage, though one study found it can be an additional stressor.41   • NPs conducting after-hours services may experience greater opportunities for career progression and autonomous practice,42 as well as increased job satisfaction.41