Identifying Electronic Health Record Usability And Safety Challenges In Pediatric Settings
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Published on: May 15, 2020
Raj M Ratwani1, Erica Savage2, Amy Will3
1Raj M. Ratwani ( raj.m.ratwani@medstar.net ) is director of the National Center for Human Factors in Healthcare, MedStar Health, and an assistant professor of emergency medicine, Department of Emergency Medicine, Georgetown University School of Medicine, both in Washington, D.C.
Insights
Electronic health record (EHR) usability issues significantly impact pediatric medication safety, leading to errors like improper dosing. Addressing system feedback and visual display challenges is crucial for improving child patient safety in healthcare.
Area of Science:
- Health Informatics
- Patient Safety
- Pediatric Care
Background:
- Pediatric patients face unique risks with electronic health records (EHRs), especially concerning medication safety.
- Existing knowledge on specific EHR usability issues contributing to pediatric medication errors is limited.
Purpose of the Study:
- To identify specific usability challenges within EHRs that contribute to medication errors in pediatric care.
- To analyze the frequency and nature of these errors and their potential impact on patient harm.
Main Methods:
- Analysis of 9,000 patient safety reports from 2012-2017 across three healthcare institutions.
- Categorization of reports to identify EHR-related usability issues and medication events.
- Assessment of potential patient harm associated with identified errors.
Main Results:
- 36% of analyzed reports indicated a usability issue contributing to a medication event.
- 18.8% of these usability-related events had the potential to cause patient harm.
- Common usability challenges included poor system feedback and visual display issues.
- Improper dosing was the most frequent type of medication error observed.
- Similar patterns of usability challenges and medication errors were consistent across all three institutions.
Conclusions:
- EHR usability significantly affects medication safety in pediatric populations.
- System feedback and visual display are critical areas for EHR improvement in pediatric settings.
- Targeted interventions focusing on these usability aspects can mitigate medication errors and enhance child patient safety.
Abstract:
Pediatric populations are uniquely vulnerable to the usability and safety challenges of electronic health records (EHRs), particularly those related to medication, yet little is known about the specific issues contributing to hazards. To understand specific usability issues and medication errors in the care of children, we analyzed 9,000 patient safety reports, made in the period 2012-17, from three different health care institutions that were likely related to EHR use. Of the 9,000 reports, 3,243 (36 percent) had a usability issue that contributed to the medication event, and 609 (18.8 percent) of the 3,243 might have resulted in patient harm. The general pattern of usability challenges and medication errors were the same across the three sites. The most common usability challenges were associated with system feedback and the visual display. The most common medication error was improper dosing.
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