Piedmont Healthcare

Piedmont Healthcare clinicians faced significant inefficiencies from overwhelming in-basket communications, with over 17 million outdated messages clogging the EHR system. Poorly designed alerts caused cognitive overload by routing notifications to non-prescribers and delivering low-value information. These issues contributed to rising clinician burnout and reduced satisfaction scores.

Piedmont revamped in-basket management by reducing message folder types, eliminating unnecessary messages, and implementing automated rules to discard irrelevant communications. Generative AI was deployed to draft clinical messages, while smart phrases and quick lists in Epic accelerated documentation. Alerts were redesigned using the 'five rights of clinical decision support' framework, with weekly clinician feedback loops to continuously refine performance. A virtual nursing pilot centralized admission, medication reconciliation, and discharge workflows across three hospitals.

Piedmont achieved a 93rd percentile ranking for the Net EHR Experience Score and similarly high rankings for clinical efficiency, quality care, and patient safety. Clinician burnout scores significantly declined between 2021 and 2023 and have remained stable since. The virtual nursing program saved bedside nurses 30–40 minutes daily and improved Press Ganey patient satisfaction scores.

• Structured weekly feedback loops with clinicians are critical for continuously improving alert design and in-basket workflows before layering in AI
• Removing 17M+ outdated messages and low-value alerts first created a cleaner foundation that made generative AI adoption more impactful
• Centralizing virtual nursing for documentation tasks (admissions, reconciliation, discharge) unlocks bedside nurse time without requiring new headcount