• J Am Med Inform Assoc · Mar 2017

    Safety huddles to proactively identify and address electronic health record safety.

    • Shailaja Menon, Hardeep Singh, Traber D Giardina, William L Rayburn, Brenda P Davis, Elise M Russo, and Dean F Sittig.
    • Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
    • J Am Med Inform Assoc. 2017 Mar 1; 24 (2): 261-267.

    ObjectiveMethods to identify and study safety risks of electronic health records (EHRs) are underdeveloped and largely depend on limited end-user reports. "Safety huddles" have been found useful in creating a sense of collective situational awareness that increases an organization's capacity to respond to safety concerns. We explored the use of safety huddles for identifying and learning about EHR-related safety concerns.DesignData were obtained from daily safety huddle briefing notes recorded at a single midsized tertiary-care hospital in the United States over 1 year. Huddles were attended by key administrative, clinical, and information technology staff. We conducted a content analysis of huddle notes to identify what EHR-related safety concerns were discussed. We expanded a previously developed EHR-related error taxonomy to categorize types of EHR-related safety concerns recorded in the notes.ResultsOn review of daily huddle notes spanning 249 days, we identified 245 EHR-related safety concerns. For our analysis, we defined EHR technology to include a specific EHR functionality, an entire clinical software application, or the hardware system. Most concerns (41.6%) involved " EHR technology working incorrectly, " followed by 25.7% involving " EHR technology not working at all. " Concerns related to "EHR technology missing or absent" accounted for 16.7%, whereas 15.9% were linked to " user errors ."ConclusionsSafety huddles promoted discussion of several technology-related issues at the organization level and can serve as a promising technique to identify and address EHR-related safety concerns. Based on our findings, we recommend that health care organizations consider huddles as a strategy to promote understanding and improvement of EHR safety.© The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

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