Difference between revisions of "Participation in EHR based simulation improves recognition of patient safety issues"
(Fixed some grammar errors, edited a few sentences for clarity, added a new incoming link, edited a reference) |
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=Introduction= | =Introduction= | ||
| − | EHR usage is prevalent in all aspects of healthcare today with several studies showing an increase in adverse patient safety issues due to the EHR-user interface. The ICU is a high volume, critical arena vulnerable to patient safety concerns due to EHR related safety issues. Stephenson et al., stated novel educational activities which incorporate use of the EHR can be used to address the concerns. <ref name="EHR">Stephenson, L., Gorsuch, A., Hersh, W., Mohan, V., & Gold, J. (2014). Participation in EHR based simulation improves recognition of patient safety issues. BMC Medical Education, 14, 224. http://www.ncbi.nlm.nih.gov/pubmed/25336294?dopt=Abstract&holding=f1000,f1000m,isrctn.</ref> The researchers used EHR based simulation exercises to show that everyday users failed to recognize most of patient safety issues in the ICU. They next sought to determine whether participation in the simulation | + | [[EMR|Electronic Health Record (EHR)]] usage is prevalent in all aspects of healthcare today with several studies showing an increase in adverse patient safety issues due to the EHR-user interface. The ICU is a high volume, critical arena vulnerable to patient safety concerns due to EHR related safety issues. Stephenson et al., stated novel educational activities which incorporate use of the EHR can be used to address the concerns.<ref name="EHR">Stephenson, L., Gorsuch, A., Hersh, W., Mohan, V., & Gold, J. (2014). Participation in EHR based simulation improves recognition of patient safety issues. BMC Medical Education, 14, 224. http://www.ncbi.nlm.nih.gov/pubmed/25336294?dopt=Abstract&holding=f1000,f1000m,isrctn.</ref> The researchers used EHR based simulation exercises to show that everyday users failed to recognize most of patient safety issues in the ICU. They next sought to determine whether participation in the simulation<ref name="simulation">http://www.healthcareitnews.com/blog/using-simulation-training-healthcare</ref> improved recognition of the patient safety issues. |
=Background= | =Background= | ||
| − | Health Information Technology for Economic and Clinical Health [[HITECH | (HITECH)]] supported the adoption of EHRs and meaningful use. From 2008 to 2012, EHR usage in US hospitals increased from 9.4% to 44.4% and the percent of hospitals adopting a comprehensive EHR increased from 1.6% to 16.9%. | + | Health Information Technology for Economic and Clinical Health [[HITECH | (HITECH)]] supported the adoption of EHRs and meaningful use. From 2008 to 2012, EHR usage in US hospitals increased from 9.4% to 44.4% and the percent of hospitals adopting a comprehensive EHR increased from 1.6% to 16.9%. The researchers stated an ICU patient generates more than 1400 data items per 24 hour period, excluding clinical notes, medication orders and details of medication administration.<ref name="EHR"></ref> |
=Methods= | =Methods= | ||
| − | The authors created a simulated patient environment within their EHR with a detailed method of the simulation exercise for evaluating use of the EHR in the ICU. | + | The authors created a simulated patient environment within their EHR with a detailed method of the simulation exercise for evaluating use of the EHR in the ICU. They later created a second simulated medical ICU patient with a different clinical scenario and different trends. Each case contained 14 safety issues with shared themes but different content. The subjects were given 10 minutes to review a case followed by a presentation of management changes. Participants were given an immediate debriefing regarding missed issues and strategies for data gathering in the EHR, followed by retesting 1 week to 1 month later with the other case. |
=Results= | =Results= | ||
| − | A total of 116 subjects were initially tested with 25 undergoing repeat testing. The researchers did not notice a difference between the initial cases in the recognition of patient safety | + | A total of 116 subjects were initially tested with 25 undergoing repeat testing. The researchers did not notice a difference between the initial cases in the recognition of patient safety issues (39.5% vs. 39.4%). There was no significant difference in the baseline performance of those participating in repeat testing compared to the cohort as a whole. For both case scenarios, recognition of safety issues was significantly higher for repeat participants as they outperformed all first time only participants regardless of training level. <ref name="EHR">Stephenson, L., Gorsuch, A., Hersh, W., Mohan, V., & Gold, J. (2014). Participation in EHR based simulation improves recognition of patient safety issues. BMC Medical Education, 14, 224. http://www.ncbi.nlm.nih.gov/pubmed/25336294?dopt=Abstract&holding=f1000,f1000m,isrctn.</ref> |
=Conclusion= | =Conclusion= | ||
Revision as of 01:48, 7 October 2015
A review of the article by Stephenson et al., Participation in EHR based simulation improves recognition of patient safety issues
Contents
Introduction
Electronic Health Record (EHR) usage is prevalent in all aspects of healthcare today with several studies showing an increase in adverse patient safety issues due to the EHR-user interface. The ICU is a high volume, critical arena vulnerable to patient safety concerns due to EHR related safety issues. Stephenson et al., stated novel educational activities which incorporate use of the EHR can be used to address the concerns.[1] The researchers used EHR based simulation exercises to show that everyday users failed to recognize most of patient safety issues in the ICU. They next sought to determine whether participation in the simulation[2] improved recognition of the patient safety issues.
Background
Health Information Technology for Economic and Clinical Health (HITECH) supported the adoption of EHRs and meaningful use. From 2008 to 2012, EHR usage in US hospitals increased from 9.4% to 44.4% and the percent of hospitals adopting a comprehensive EHR increased from 1.6% to 16.9%. The researchers stated an ICU patient generates more than 1400 data items per 24 hour period, excluding clinical notes, medication orders and details of medication administration.[1]
Methods
The authors created a simulated patient environment within their EHR with a detailed method of the simulation exercise for evaluating use of the EHR in the ICU. They later created a second simulated medical ICU patient with a different clinical scenario and different trends. Each case contained 14 safety issues with shared themes but different content. The subjects were given 10 minutes to review a case followed by a presentation of management changes. Participants were given an immediate debriefing regarding missed issues and strategies for data gathering in the EHR, followed by retesting 1 week to 1 month later with the other case.
Results
A total of 116 subjects were initially tested with 25 undergoing repeat testing. The researchers did not notice a difference between the initial cases in the recognition of patient safety issues (39.5% vs. 39.4%). There was no significant difference in the baseline performance of those participating in repeat testing compared to the cohort as a whole. For both case scenarios, recognition of safety issues was significantly higher for repeat participants as they outperformed all first time only participants regardless of training level. [1]
Conclusion
The authors concluded participation in EHR simulation improved overall EHR use and identification of patient safety issues. The article did not identify whether the improvement in performance was due to improved utilization of the EHR or was from the redundancy of exposure to the clinical information by those who participated in the study.
Comments
The authors believed the identification of patient safety issues improved with repeated simulation and the increase was credited to the simulation itself. I believe the repetition of exposure to information through the retested contributed to the improvement.
References
- ↑ 1.0 1.1 1.2 Stephenson, L., Gorsuch, A., Hersh, W., Mohan, V., & Gold, J. (2014). Participation in EHR based simulation improves recognition of patient safety issues. BMC Medical Education, 14, 224. http://www.ncbi.nlm.nih.gov/pubmed/25336294?dopt=Abstract&holding=f1000,f1000m,isrctn.
- ↑ http://www.healthcareitnews.com/blog/using-simulation-training-healthcare
