Quality and safety implications of emergency department information systems.

The Health Information Technology for Economic and Clinical Health Act of 2009 and the Centers for Medicare & Medicaid Services "meaningful use" incentive programs, in tandem with the boundless additional requirements for detailed reporting of quality metrics, have galvanized hospital efforts to imp...

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Publicado en:Annals of Emergency Medicine Vol. 62; no. 4; pp. 399 - 408
Autores principales: Farley, Heather L, Baumlin, Kevin M, Hamedani, Azita G, Cheung, Dickson S, Edwards, Michael R, Fuller, Drew C, Genes, Nicholas, Griffey, Richard T, Kelly, John J, McClay, James C, Nielson, Jeff, Phelan, Michael P, Shapiro, Jason S, Stone-Griffith, Suzanne, Pines, Jesse M
Formato: research Journal Article
Publicado: Elsevier B.V. Oct2013
Acceso en línea:Ver este registro en EBSCOhost
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        10.1016/j.annemergmed.2013.05.019
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        atl: Quality and safety implications of emergency department information systems.
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          Farley, Heather L
          Baumlin, Kevin M
          Hamedani, Azita G
          Cheung, Dickson S
          Edwards, Michael R
          Fuller, Drew C
          Genes, Nicholas
          Griffey, Richard T
          Kelly, John J
          McClay, James C
          Nielson, Jeff
          Phelan, Michael P
          Shapiro, Jason S
          Stone-Griffith, Suzanne
          Pines, Jesse M
        affil: Department of Emergency Medicine, Christiana Care Health System, Newark, DE; Jefferson Medical College, Philadelphia, PA. Electronic address: hfarley@christianacare.org.
      sug:
        subj:
          Emergency Service Standards
          Hospital Information Systems Standards
          Patient Safety Standards
          Laboratory Equipment and Supplies
          Communication
          Electronic Health Records Standards
          Treatment Errors Prevention and Control
          Quality of Health Care Standards
      ab: The Health Information Technology for Economic and Clinical Health Act of 2009 and the Centers for Medicare & Medicaid Services "meaningful use" incentive programs, in tandem with the boundless additional requirements for detailed reporting of quality metrics, have galvanized hospital efforts to implement hospital-based electronic health records. As such, emergency department information systems (EDISs) are an important and unique component of most hospitals' electronic health records. System functionality varies greatly and affects physician decisionmaking, clinician workflow, communication, and, ultimately, the overall quality of care and patient safety. This article is a joint effort by members of the Quality Improvement and Patient Safety Section and the Informatics Section of the American College of Emergency Physicians. The aim of this effort is to examine the benefits and potential threats to quality and patient safety that could result from the choice of a particular EDIS, its implementation and optimization, and the hospital's or physician group's approach to continuous improvement of the EDIS. Specifically, we explored the following areas of potential EDIS safety concerns: communication failure, wrong order-wrong patient errors, poor data display, and alert fatigue. Case studies are presented that illustrate the potential harm that could befall patients from an inferior EDIS product or suboptimal execution of such a product in the clinical environment. The authors have developed 7 recommendations to improve patient safety with respect to the deployment of EDISs. These include ensuring that emergency providers actively participate in selection of the EDIS product, in the design of processes related to EDIS implementation and optimization, and in the monitoring of the system's ongoing success or failure. Our recommendations apply to emergency departments using any type of EDIS: custom-developed systems, best-of-breed vendor systems, or enterprise systems.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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