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Related Concept Videos

Types of Reports II: Incident or Occurrence Report01:21

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An Incident or Occurrence Report in a healthcare setting is a crucial document used to record any unexpected occurrence that may or may not have affected a patient, employee, or visitor. Such reports are critical to improving patient safety and include all details leading up to and including the event.
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EHR Improvement Using Incident Reports.

Tesfay Teame1, Tor Stålhane2, Øystein Nytrø2

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Studies in Health Technology and Informatics
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This study used the "Five Whys" method to analyze electronic health record (EHR) software failures. Human and organizational errors were identified as root causes, highlighting the need for better maintenance and training.

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Clinical softwareFailure analysisFive WhysSoftware Maintenance

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Area of Science:

  • Health Informatics
  • Software Engineering
  • Clinical Systems Analysis

Background:

  • Clinical software, particularly Electronic Health Records (EHRs), are critical for modern healthcare delivery.
  • Software failures in clinical settings can lead to significant disruptions and patient safety concerns.
  • Reactive improvement strategies are often employed following incidents.

Purpose of the Study:

  • To identify root causes of clinical software failures using incident analysis.
  • To propose reactive improvements for EHR software based on identified failure patterns.
  • To evaluate the effectiveness of the "Five Whys" method in analyzing descriptive incident data.

Main Methods:

  • Employed the "Five Whys" technique for root cause analysis of EHR software incidents.
  • Utilized descriptive data and relied on domain expert input for the analysis.
  • Focused on identifying recurring patterns and underlying causes of software failures.

Main Results:

  • Identified two major root causes for EHR software failures.
  • Determined that human and organizational errors are significant contributors to EHR failures.
  • Highlighted the need for increased resource allocation towards system maintenance and user training.

Conclusions:

  • Human and organizational factors are primary drivers of EHR software failures.
  • Enhanced resource allocation for system maintenance and comprehensive user training are crucial for improving EHR software reliability.
  • The "Five Whys" method is a viable approach for analyzing descriptive incident data in clinical software improvement.