Advancing perinatal patient safety through application of safety science principles using health IT

BMC Medical Informatics and Decision Making

Research Article

Kamila Mistry¹  Leila Kahwati²  Asta Sorensen²  Beth Lasater²  Jennifer Webb²  Samantha Sommerness³ 

[1] Agency for Healthcare Research and Quality, 5600 Fishers Lane, Mailbox: 06E81B, 20857, Rockville, MD, USA;RTI International, 3040 E. Cornwallis Rd, 27709, Research Triangle Park, NC, USA;University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, 55455, Minneapolis, MN, USA;

关键词: Perinatal health;    Labor and delivery;    Health IT;    Electronic health record (EHR);    Patient safety;    Quality improvement;    Safety science principles;    Standardization;    HIT implementation;   

DOI  :  10.1186/s12911-017-0572-8

 received in 2017-04-28, accepted in 2017-12-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. The use of health IT to apply safety science principles (e.g., standardization) to L&D unit processes may further advance perinatal safety.MethodsSemi-structured interviews were conducted with L&D units participating in the Agency for Healthcare Research and Quality’s (AHRQ’s) Safety Program for Perinatal Care (SPPC) to assess units’ experience with program implementation. Analysis of interview transcripts was used to characterize the process and experience of using health IT for applying safety science principles to L&D unit processes.ResultsForty-six L&D units from 10 states completed participation in SPPC program implementation; thirty-two (70%) reported the use of health IT as an enabling strategy for their local implementation. Health IT was used to improve standardization of processes, use of independent checks, and to facilitate learning from defects. L&D units standardized care processes through use of electronic health record (EHR)-based order sets and use of smart pumps and other technology to improve medication safety. Units also standardized EHR documentation, particularly related to electronic fetal monitoring (EFM) and shoulder dystocia. Cognitive aids and tools were integrated into EHR and care workflows to create independent checks such as checklists, risk assessments, and communication handoff tools. Units also used data from EHRs to monitor processes of care to learn from defects. Units experienced several challenges incorporating health IT, including obtaining organization approval, working with their busy IT departments, and retrieving standardized data from health IT systems.ConclusionsUse of health IT played an integral part in the planning and implementation of SPPC for participating L&D units. Use of health IT is an encouraging approach for incorporating safety science principles into care to improve perinatal safety and should be incorporated into materials to facilitate the implementation of perinatal safety initiatives.

【 授权许可】

CC BY   
© The Author(s). 2017