Take these steps to reduce unproductive charting for nurses, says KLAS

Nurses report increased stress levels, and they have said a major contributor to burnout is unproductive charting — a burden that the KLAS Arch Collaborative says hospitals and health care systems can help reduce.

A new KLAS report describes how – outlining a three-step process that healthcare organizations can follow to reduce charting and allow nurses to focus more on patient care.


In the American Nurses Foundation’s latest Mental Health and Wellness questionnaireto which 7,400 nurses responded between April 24 and May 26, 2023, nearly two-thirds of nurses said their job caused them a lot of stress, while 45% agreed or strongly agreed that electronic health records frustrate their day.

After looking at the data, KLAS researchers said that by knowing and acting on nurse feedback, redesigning problematic workflows and addressing employee knowledge gaps, healthcare organizations can improve nurse productivity and well-being, reduce turnover reduce and save on recruitment costs.

“Arch Collaborative data shows that unproductive mapping is a significant waste of time,” KLAS researchers said. “Specifically, 35% of nurses report spending three or more hours per week on unproductive charting.”

The data identified a link between poor nursing efficiency and higher rates of burnout.

“Things that need to be mapped are borderline ridiculous and make it difficult to provide patient care due to the sheer volume of mapped data,” one nurse responded in an Arch Collaborative EHR experience survey.

In their new report, the researchers outlined how the three-step process reduces unproductive tasks, frees up time and reduces documentation stress.

“Efforts to reduce unnecessary charting should focus on helping nurses feel that the EHR enhances rather than hinders their delivery of patient care,” KLAS researchers said in Enabling nurses to focus on patient care in 2024.

“Data from Arch Collaborative indicates that nurses who spend less time on unproductive charting have higher overall EHR satisfaction than nurses who report more unproductive charting.”

The first step in reversing these experiences is knowing where to start, researchers say. To identify nurses’ frustrations within an organization, KLAS recommends that healthcare providers conduct internal perception surveys and collect EHR usage data and other sources to inform efficiency needs and prioritize workflow improvements.

“End-user feedback is critical,” they said. “After the changes are implemented, you need to measure again to measure success.”

Once problem workflows with the greatest need for intervention are identified, health care systems and hospitals can redesign them and establish documentation change processes, they said.

That redesign team, they noted, should be multidisciplinary, composed of frontline nurses, nursing leadership, information scientists and compliance specialists.

The third step is to address workflows where knowledge gaps (rather than cumbersome flowcharts) are causing nurse mapping frustrations.

“Inform nurses of any changes to flowcharts based on the opportunities identified in Step 2,” the researchers said. They also advised on the use of charts by exception as an organizational standard to reduce duplicate charts.


Resolving pesky daily documentation irritants can prevent worsening post-pandemic healthcare burnout if healthcare organizations intervene early and don’t dismiss their employees’ concerns.

In particular, nurses’ enthusiasm for EHR duties has been a hot topic since the pandemic began, with improved onboarding, ongoing training, board integration, and increased communication efforts often cited as remedies for the nurse burnout crisis .

A 2022 survey for a KLAS nursing manual showed a significant decline, with only 59% of nurses surveyed finding ongoing training useful, compared to 71% of respondents in 2020.

Involving nurses in EHR management and decision-making is an important practice to implement because organizations with multidisciplinary teams see higher EHR satisfaction, the researchers said.

“Organizations should focus on helping nurses identify the core problem and then work with analysts to find a solution,” KLAS said.


“Nurses who log more than three hours of unproductive charting in a week report higher levels of burnout than those who do not,” the KLAS researchers said in the new report. “Given this added stress, it is not surprising that these nurses also report a greater likelihood of leaving their organizations.”

Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org

Healthcare IT News is a HIMSS Media publication.