Electronic Health Records
Electronic Health Records
EHR Implementation:
A Vendor’s Diary
This is the first in an occasional series chronicling the implementation of an electronic health record in a small community hospital system in rural New Hampshire. Serious discussion about the implementation began in 2009, during a time of seismic change in healthcare and healthcare IT.
Human Factors 101
Human Factors 101
Affordances and Constraints Improve Reliability
In the first article in this series, we introduced concepts of human factors engineering (HFE) and their application to healthcare. We discussed how healthcare traditionally relies on the “weak aspects of cognition” (short term memory, attention to details, vigilance, multitasking etc.) and how that contributes to many of the errors experienced in healthcare.
Safety Culture: Building a Culture of Safety
Safety Culture
Building a Culture of Safety
In the 10-plus years since the inaugural publication of the Institute of Medicine (IOM) study on medical error, To Err Is Human, there has been surprisingly little progress in reducing the rate of medical error, despite the adoption of technologies specifically intended to combat medical errors. A growing number of people attribute this lack of progress to fundamental flaws in the American healthcare culture that prevent success.
Health IT & Quality
Health IT & Quality
Regulate HIT Tools as Medical Devices? Yes and No
The Food and Drug Administration recently announced it is reconsidering its previous decision to exclude health information technology (HIT) tools from regulation as medical devices. When last evaluated in the late 1990s, this decision made common sense. At that time HIT consisted of rudimentary clinical documentation systems, electronic reference materials, and administrative applications.
Editor’s Notebook: The unTechnology Conference
Editor’s Notebook
The unTechnology Conference
Many sports fans are familiar with the quip, “Last night I went to a fight, and a hockey game broke out.” Well, in early May, I went to a technology conference, and a patient safety meeting broke out. I didn’t expect the conference to be run-of-the-mill; the unSummit, by its name, signals that it offers an alternative conference experience and claims to offer high-quality, practical advice.
Safety Huddles for a Culture of Safety
Safety Huddles for a Culture of Safety
When the Institute of Medicine (IOM) published To Err Is Human: Building a Safer Health System in 2000, the executives and quality and patient safety staff at Gundersen Lutheran immediately started discussions around issues emphasized in the report.
Common Cause Analysis
Common Cause Analysis
To improve medication safety, many healthcare systems implement a technology (such as barcode at point of care) or a best practice (such as double-check of high-risk medications). This approach turns performance improvement into experimentation with other people’s solutions for other people’s system problems — the assumption being all providers share the same system problems.
Post-Discharge Call Programs – Improving Satisfaction and Safety
Post-Discharge Call Programs
Improving Satisfaction and Safety
For patients coming home from the hospital after surgery, an emergency department (ED) visit or any other inpatient stay, the change in location has both positive and negative possibilities. On one hand, because the patient is returning to familiar surroundings and routines, recovery may be easier. On the other hand, it may be harder.
Medication Reconciliation: A Survey of Community Pharmacies and Emergency Departments
Medication Reconciliation: A Survey of Community Pharmacies and Emergency Departments
In any given week, 4 out of every 5 U.S. adults will use prescription medicines, over-the-counter drugs, or dietary supplements. Poor communication of a patient’s medication-use history between community practitioners and emergency department personnel contributes to many adverse drug events and can be a potential source of harm to patients.
Florida Hospitals and Surgeons Launch Ambitious Initiative to Improve Health Care Quality
Florida hospitals and surgeons launched a significant new initiative to
improve patient safety and the quality of surgical care while reducing
costs throughout the state. The Florida Surgical Care Initiative
(FSCI), a joint initiative of the Florida Hospital Association (FHA)
and the American College of Surgeons (ACS) and its Florida chapter, is
a unique statewide collaboration that will focus on reducing surgical
complications and improving the quality of care in participating
hospitals.