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Computer-based simulation to reduce EHR-related chemotherapy ordering errors.

Kirk D Wyatt¹, Elizabeth B Freedman², Grace M Arteaga³

¹Division of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, MN, USA.

Cancer Medicine

|October 1, 2020

Summary

Simulation-based training improved healthcare providers' ability to identify and mitigate chemotherapy ordering errors in electronic health records (EHRs). This training is valuable when EHR customization is limited, enhancing patient safety.

Keywords:

electronic health records high fidelity simulation training medical informatics patient harm patient safety simulation training

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Area of Science:

Medical Informatics
Patient Safety
Healthcare Simulation

Background:

Electronic health records (EHRs) contribute to patient harm within complex sociotechnical systems.
Chemotherapy ordering is a high-risk process prone to errors with severe consequences.
Limited EHR customization restricts institutional mitigation of ordering errors.

Purpose of the Study:

To evaluate the effectiveness of simulation-based training in improving chemotherapy ordering error identification and mitigation.
To assess if simulation training can reduce provider susceptibility to EHR-related safety vulnerabilities.

Main Methods:

Pediatric hematology/oncology providers participated in EHR simulations.
Providers identified and mitigated safety risks at baseline and follow-up.
Training involved one-on-one reviews and group sessions; follow-up assessed improvements and real-world impact.

Main Results:

Providers improved from identifying/mitigating an average of 5.5 to 7.4 risks (p=0.030).
25% of providers reported preventing real-world patient safety events post-training.

Conclusions:

Simulation-based training enhances providers' ability to manage chemotherapy ordering errors in EHRs.
This training is a viable strategy when EHR customization is not feasible.