Singh H et al, JAMA internal medicine, 2013
IMPORTANCE
Diagnostic errors are an understudied aspect of ambulatory patient safety.
OBJECTIVES
To determine the types of diseases missed and the diagnostic processes involved in cases of confirmed diagnostic errors in primary care settings and to determine whether record reviews could shed light on potential contributory factors to inform future interventions.
[ More ]
Middleton B et al, J Am Med Inform Assoc, 2013
In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems.
[ More ]
Adelman JS et al, J Am Med Inform Assoc, 2012
Objective
To evaluate systems for estimating and preventing wrong-patient electronic orders in computerized physician order entry systems with a two-phase study.
[ More ]
Hyman D et al, Pediatrics, 2012
OBJECTIVE:
To determine whether an order verification screen, including a patient photograph, is an effective strategy for reducing the risk that providers will place orders in an unintended patient’s electronic medical record (EMR).
[ More ]
Linder JA et al, J Am Med Inform Assoc, 2012
Objective
Physicians who more intensively interact with electronic health records (EHRs) through their documentation style may pay greater attention to coded fields and clinical decision support and thus may deliver higher quality care. We measured the quality of care of physicians who used three predominating EHR documentation styles: dictation, structured documentation, and free text.
[ More ]
Kutney-Lee A, Kelly D. The Journal of Nursing Administration, 41(11)
The aim of this study was to examine the effect of having a basic electronic health record (EHR) on nurse-assessed quality of care, including patient safety. Few large-scale studies have examined how adoption of EHRs may be associated with quality of care. A cross-sectional, secondary analysis of nurse and hospital survey data was conducted. The final sample included 16,352 nurses working in 316 hospitals in 4 states.
[ More ]
Holden RJ. Journal of Patient Safety, 7(4)
Objectives:
For electronic health record (EHR) systems to have a positive impact on patient safety, clinicians must be able to use these systems effectively after they are made available. This study’s objective is to identify and describe facilitators and barriers to physicians’ use of EHR systems.
Methods:
Twenty research interviews were conducted with attending physicians who were using EHR at 1 of 2 Midwest community hospitals and/or at their respective outpatient clinics.
[ More ]
Coiera E et al, J Am Med Inform Assoc, 19(1)
There is a paradox in the relationship between information and communication technology (ICT) and patient safety. ICT can improve the quality, safety and effectiveness of clinical services and patient outcomes, although the evidence base for this is sometimes weak. As a consequence, the rapid deployment of ICT on a national scale is a priority for many nations faced with a diminishing clinical workforce, increasing workloads, and resource constraints.
[ More ]
Al-Dorzi HM et al, BMC Medical Informatics and Decision Making, 11
Background
Computerized physician order entry (CPOE) systems are recommended to improve patient safety and outcomes. However, their effectiveness has been questioned. Our objective was to evaluate the impact of CPOE implementation on the outcome of critically ill patients.
[ More ]
Singh H et al, Journal of Patient Safety, 2011
Electronic health records (EHRs) have potential quality and safety benefits. However, reports of EHR-related safety hazards are now emerging. The Office of the National Coordinator for Health Information Technology recently sponsored an Institute of Medicine committee to evaluate how health information technology use affects patient safety. In this article, we propose the creation of a national EHR oversight program to provide dedicated surveillance of EHR-related safety hazards and to promote learning from identified errors, close calls, and adverse events. The program calls for data gathering, investigation/analysis, and regulatory components. The first 2 functions will depend on institution-level EHR safety committees that will investigate all known EHR-related adverse events and near-misses and report them nationally using standardized methods.
[ More ]
Jha AK, Classen DC. N Engl J Med, 365(19)
More than a decade ago, the Institute of Medicine released its famous report To Err Is Human, which set an ambitious agenda for the United States to reduce the number of Americans who were hurt or killed by medical errors and adverse events.
[ More ]
Connor AJ et al, European Journal of Ophthalmology, 21(5)
Purpose.
Prescription and drug errors are common causes of adverse clinical events, posing a significant risk to safe patient care. Although there has been a movement to increase the use of electronic prescribing, concerns over feasibility suggest that improving the design of written prescriptions to minimize missing information may still be worthwhile. This retrospective cross-sectional study examined the effect on prescription completeness of electronic prescriptions and adding information prompts to written prescriptions. We hypothesized that electronic prescription would be superior to written prescriptions on prescription completeness and the inclusion of information prompts in written prescriptions would result in increased recording of the prompted information.
[ More ]
Gearing P et al, Journal of Healthcare Information Management, 20(4)
As technology becomes more sophisticated in healthcare, there is increasing need to measure its impact on key quality indicators, such as error reduction, patient safety, and cost-benefit ratios. When a product is designed to decrease medical errors, the baseline error rate must be determined before implementation to accurately measure the impact. Given the opportunity to adopt a technology that would eliminate the need to manually document vital signs, a large Florida hospital decided to measure the current process and error rate of vital signs documentation.
[ More ]
Murff HJ et al, JAMA, 306(8)
CONTEXT
Currently most automated methods to identify patient safety occurrences rely on administrative data codes; however, free-text searches of electronic medical records could represent an additional surveillance approach.
OBJECTIVE
To evaluate a natural language processing search-approach to identify postoperative surgical complications within a comprehensive electronic medical record.
[ More ]
Sittig DF, Singh H. Archives of Internal Medicine, 171(14)
Despite the promise of health information technology (HIT), recent literature has revealed possible safety hazards associated with its use. The Office of the National Coordinator for HIT recently sponsored an Institute of Medicine committee to synthesize evidence and experience from the field on how HIT affects patient safety. To lay the groundwork for defining, measuring, and analyzing HIT-related safety hazards, we propose that HIT-related error occurs anytime HIT is unavailable for use, malfunctions during use, is used incorrectly by someone, or when HIT interacts with another system component incorrectly, resulting in data being lost or incorrectly entered, displayed, or transmitted.
[ More ]
Hampton T. JAMA, 306(2)
Up to 1 million patients in the United States may be taking 2 medications that can lead to unexpected increases in blood glucose levels when used simultaneously. Data mining techniques have revealed that the combination of the antidepressant paroxetine and the cholesterol-lowering medication pravastatin may cause this adverse effect (Tatonetti NP et al. Clin Pharmacol Ther. doi: 10.1038/clpt.2011.83 [published online ahead of print May 25, 2011]).
[ More ]
Borycki EM et al, Patient Safety Informatics - Adverse Drug Events, Human Factors and IT Tools for Patient Medication Safety, 2011
Electronic health records (EHRs) promise to improve and streamline healthcare through electronic entry and retrieval of patient data. Furthermore, based on a number of studies showing their positive benefits, they promise to reduce medical error and make healthcare safer. However, a growing body of literature has clearly documented that if EHRS are not designed properly and with usability as an important goal in their design, rather than reducing error, EHR deployment has the potential to actually increase medical error. In this paper we describe our approach to engineering (and reengineering) EHRs in order to increase their beneficial potential while at the same time improving their safety.
[ More ]
Redwood S et al, BMC Medical Informatics and Decision Making, 11(1)
BACKGROUND:
Even though electronic prescribing systems are widely advocated as one of the most effective means of improving patient safety, they may also introduce new risks that are not immediately obvious. Through the study of specific incidents related to the processes involved in the administration of medication, we sought to find out if the prescribing system had unintended consequences in creating new errors. The focus of this study was a large acute hospital in the Midlands in the United Kingdom, which implemented a Prescribing, Information and Communication System (PICS).
[ More ]
Furukawa MF et al, Medical Care Research and Review, 68(3)
Electronic medical records (EMR) have the potential to improve nursing care in the hospital setting. This study estimated the association of EMR implementation with nurse staffing levels, skill mix, contract/agency percent, and nurse-sensitive patient outcomes in U.S. hospitals. Data on nurse staffing and patient outcomes came from the 2004-2008 National Database of Nursing Quality Indicators. Data on EMR implementation came from the 2004-2008 HIMSS Analytics Database.
[ More ]
Gee T. Patient Safety And Quality Healthcare, January/February 2011
Papers reporting serious adverse events (Nebeker, 2005; Yong, 2005) relating to the use of commercial healthcare IT (HIT) applications received significant publicity in 2005. Many of the reports at that time focused on the configuration of decision support systems used in computerized physician order entry (CPOE) systems.
[ More ]
