Resilient practices in maintaining safety of health information technologies

Michael W. Smith, Joan Ash, Dean F. Sittig, Hardeep Singh

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Electronic health record systems (EHRs) can improve safety and reliability of health care, but they can also introduce new vulnerabilities by failing to accommodate changes within a dynamic EHR-enabled health care system. Continuous assessment and improvement is thus essential for achieving resilience in EHR-enabled health care systems. Given the rapid adoption of EHRs by many organizations that are still early in their experiences with EHR safety, it is important to understand practices for maintaining resilience used by organizations with a track record of success in EHR use. We conducted interviews about safety practices with 56 key informants (including information technology managers, chief medical information officers, physicians, and patient safety officers) at two large health care systems recognized as leaders in EHR use. We identified 156 references to resilience-related practices from 41 informants. Framework analysis generated five categories of resilient practices: (a) sensitivity to dynamics and interdependencies affecting risks, (b) basic monitoring and responding practices, (c) management of practices and resources for monitoring and responding, (d) sensitivity to risks beyond the horizon, and (e) reflecting on risks with the safety and quality control process itself. The categories reflect three functions that facilitate resilience: reflection, transcending boundaries, and involving sharp-end practitioners in safety management.

Original languageEnglish (US)
Pages (from-to)265-282
Number of pages18
JournalJournal of Cognitive Engineering and Decision Making
Volume8
Issue number3
DOIs
StatePublished - Sep 8 2014

Fingerprint

Medical Informatics
health information
Information technology
information technology
Health
Delivery of Health Care
Health care
Safety
resilience
health care
Organizations
Safety Management
Electronic Health Records
Practice Management
Patient Safety
Quality Control
monitoring
Monitoring
control process
quality control

Keywords

  • domains
  • health care delivery
  • information systems
  • naturalistic decision making
  • resilience engineering
  • topics

ASJC Scopus subject areas

  • Engineering (miscellaneous)
  • Applied Psychology

Cite this

Resilient practices in maintaining safety of health information technologies. / Smith, Michael W.; Ash, Joan; Sittig, Dean F.; Singh, Hardeep.

In: Journal of Cognitive Engineering and Decision Making, Vol. 8, No. 3, 08.09.2014, p. 265-282.

Research output: Contribution to journalArticle

Smith, Michael W. ; Ash, Joan ; Sittig, Dean F. ; Singh, Hardeep. / Resilient practices in maintaining safety of health information technologies. In: Journal of Cognitive Engineering and Decision Making. 2014 ; Vol. 8, No. 3. pp. 265-282.
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