Human factors and systems simulation methods to optimize peri-operative EHR design and implementation

Area of Science:

• Healthcare Informatics
• Human Factors Engineering
• Patient Safety

Background:

• Electronic Health Records (EHR) adoption presents challenges, including potential safety threats and inefficiencies if not aligned with clinical workflows.
• A transition to a new EHR system in a pediatric hospital necessitated a proactive approach to ensure system readiness.

Purpose of the Study:

• To proactively test a new EHR system using simulation and human factors methods before its official launch.
• To enhance the safety, efficiency, and usability of the EHR within a peri-operative pediatric setting.

Main Methods:

• A quality improvement study conducted from September 2023 to April 2024 at a children's hospital.
• Two cycles of usability testing via Zoom and in situ simulations with interprofessional peri-operative teams.
• Integration of human factors and patient safety principles into recommendations derived from qualitative data.

Main Results:

• A total of 475 recommendations were generated to optimize the EHR's safety, efficiency, and usability.
• Usability and system issues, including latent safety threats impacting patient care, were identified.
• Critical usability issues were uncovered and mitigated prior to the EHR go-live date.

Conclusions:

• Proactive usability testing and simulation are crucial for identifying and mitigating risks associated with new EHR implementations.
• Integrating human factors principles leads to significant improvements in EHR safety, efficiency, and user experience.
• Early identification and resolution of EHR issues are vital for ensuring safe and high-quality patient care in pediatric settings.