Difference between revisions of "Measuring and improving patient safety through health information technology: The Health IT Safety Framework"

From Clinfowiki
Jump to: navigation, search
(Facilitate organizational preparedness)
(Sociotechnical Work System)
Line 19: Line 19:
 
=== Sociotechnical Work System ===
 
=== Sociotechnical Work System ===
  
The Sociotechnical Work System is comprised of 8 components:  
+
[[Sociotechnical systems]] are comprised of 8 components:  
 
*Hardware and software
 
*Hardware and software
 
*Clinical content
 
*Clinical content

Revision as of 03:03, 1 October 2015

This is a review of Hardeep Singh and Dean Sittig's "Measuring and improving patient safety through health information technology: The Health IT Safety Framework." [1]

Introduction

Despite rapid adoption and use of health information technology (HIT or health IT) with the potential to improve patient safety outcomes, there is still no clear way to measure the impact of this technology on these outcomes. The health IT safety framework was created to contextualize "health IT-related patient safety measurement, monitoring, and improvement." [1]

Framework Rationale

Most organizations have not been focusing on health IT-related patient safety as they race to implement systems that meet meaningful use (MU) criteria. This framework will help put measurement of health IT-related patient safety at the forefront of an organization's existing patient safety efforts, which will be essential as use of HIT continues to flourish. The 3 essential elements this framework addresses are:

"1. refine the science of measuring health IT-related patient safety 2. make health IT-related patient safety an organizational priority by securing commitment from organizational leadership and refocusing the organization's clinical governance structure to facilitate measurement and monitoring 3. develop an environment that is conducive to detecting, fixing and learning from system vulnerabilities." [1]

Overview of Framework

Follows principles of "continuous quality improvement."

Sociotechnical Work System

Sociotechnical systems are comprised of 8 components:

  • Hardware and software
  • Clinical content
  • Human-Computer interface
  • People
  • Workflow and communication
  • Internal organizational features
  • External rules and regulations
  • Measurement and monitoring

The HITS Framework presupposes that patient safety events must be considered in the context of these 8 sociotechnical domains.

Measurement of three overlapping domains of HITS

In addition to the sociotechnical system, there are 3 domains of health IT implementation and use:

  • Safe health IT
  • Safe use of health IT
  • Using health IT to improve safety

Measurement must occur in all 3 domains, both retrospectively and proactively in order to learn from past events and prevent those that could occur in the future.

Measures should be impactful, scientifically acceptable, feasible, usable, and transparent.

Expected Measurement Impact

Diverse stakeholders must come together to improve measurement of safety concerns related to or able to be determined via effective use of health IT. Organizations must continue to learn from the data these measures generate and must take a "360-degree approach" to analyzing and reacting to said data. If an organization prioritizes these efforts, they will develop a culture of health IT-related patient safety and will be able to learn how to improve safety of their HIT systems.

Use of the Framework to Overcome Challenges of Real-World Measurement

The framework's components can work together to advance measurement of HIT-related safety.

Uncover hidden HIT safety risks

Health care organizations need to be aware of the potential existence of "hidden" safety risks related to HIT. Proper measurement and analysis can help expose such concerns, and in order to address them, organizations should consider bringing in multidisciplinary teams of professionals with experience in these sorts of issues, such as informaticists or human factors engineers.

Facilitate organizational preparedness

Prior to implementing these measurements, organizations need to assess their current state of HIT safety and understand how this is integrated with their patient safety paradigm. There are tools to help organizations assess risk, such as the ONC sponsored SAFER guides (ONC Issues Guides for SAFER EHRs).

Advance Current Measurement Methods

Identify top priorities for measure development

Comments

References

  1. 1.0 1.1 1.2 Hardeep Singh and Dean F. Sittig. Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ Qual Saf. Published online first 2015 September. http://www.ncbi.nlm.nih.gov/pubmed/26369894?dopt=Abstract