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

Mirette Dubé^1,2, Jonathan D Hron^3,4, Susan Biesbroek⁵

¹Healthcare Systems Simulation International Inc, 51 GlenEagles Terrace, Cochrane, AB, T4C 1W4, Canada. Mirette@HealthcareSSI.com.

Advances in Simulation (London, England)

|April 24, 2025

Summary

Proactive testing of a new Electronic Health Record (EHR) using simulation and human factors methods identified critical issues before implementation. This improved EHR safety, efficiency, and usability in a pediatric hospital setting.

Keywords:

Electronic health record Healthcare Human factors Information technology Patient safety Quality improvement Simulation Systems simulation Usability testing

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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.