Identifying Electronic Health Record Usability And Safety Challenges In Pediatric Settings

被引：91

作者：

Ratwani, Raj M. ^{[1
,2
]}

Savage, Erica ^{[3
]}

Will, Amy ^{[4
]}

Fong, Allan ^{[4
]}

Karavite, Dean ^{[5
]}

Muthu, Naveen ^{[6
,7
]}

Rivera, A. Joy ^{[8
]}

Gibson, Cori ^{[8
]}

Asmonga, Don ^{[9
]}

Moscovitch, Ben ^{[9
]}

Grundmeier, Robert ^{[7
,10
]}

Rising, Josh ^{[11
]}

机构：

[1] Georgetown Univ, Sch Med, Natl Ctr Human Factors Healthcare, MedStar Hlth, Washington, DC 20057 USA

[2] Georgetown Univ, Sch Med, Emergency Med, Dept Emergency Med, Washington, DC 20057 USA

[3] MedStar Hlth, Ambulatory Qual & Safety, Columbia, MD USA

[4] MedStar Hlth, Natl Ctr Human Factors Healthcare, Columbia, MD USA

[5] Childrens Hosp Philadelphia, Dept Biomed & Hlth Informat, Philadelphia, PA 19104 USA

[6] Univ Penn, Perelman Sch Med, Cognit Informat Grp, Dept Biomed & Hlth Informat,Childrens Hosp Philad, Philadelphia, PA 19104 USA

[7] Univ Penn, Perelman Sch Med, Pediat, Philadelphia, PA 19104 USA

[8] Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA

[9] Pew Charitable Trusts, Hlth Informat Technol Initiat, Washington, DC USA

[10] Univ Penn, Perelman Sch Med, Dept Biomed & Hlth Informat, Clin Informat,Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[11] Pew Charitable Trusts, Healthcare Programs, Philadelphia, PA USA

来源：

HEALTH AFFAIRS | 2018年 / 37卷 / 11期

基金：

美国医疗保健研究与质量局;

关键词：

PATIENT SAFETY; MEDICATION ERRORS; SYSTEMS; PERFORMANCE; CARE;

D O I：

10.1377/hlthaff.2018.0699

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

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.

引用

页码：1752 / 1759

页数：8

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