Participation in EHR based simulation improves recognition of patient safety issues

Area of Science:

• Medical Education
• Patient Safety
• Health Informatics

Background:

• Electronic health records (EHR) are increasingly used in clinical settings.
• Studies show EHR user interfaces can lead to patient safety issues.
• The intensive care unit (ICU) presents unique challenges for EHR integration due to data complexity.

Purpose of the Study:

• To assess the effectiveness of a novel EHR-based simulation exercise in improving the recognition of patient safety issues.
• To determine if participation in the simulation enhances user performance in identifying critical safety concerns within the ICU environment.

Main Methods:

• Developed two ICU cases within an EHR simulation environment, each containing 14 safety issues.
• Residents reviewed cases, received management presentations, and immediate debriefings.
• Repeated testing was conducted with a subset of participants on a different case at least one week later.

Main Results:

• No significant difference in safety issue recognition between the two cases (39.5% vs. 39.4%).
• Repeat participants showed significantly higher recognition rates compared to first-time participants.
• Individual performance improved from 39.9% to 63.6% (p=0.0002), with greater improvement in those with lower baseline performance.

Conclusions:

• Participation in EHR simulation training demonstrably improves EHR usability and the identification of patient safety issues.
• The simulation is an effective educational tool for enhancing critical safety issue detection in the ICU.