Healthcare practitioner behaviours that influence unsafe use of hospital information systems

2019 ◽  
Vol 26 (1) ◽  
pp. 420-434 ◽  
Author(s):  
Lizawati Salahuddin ◽  
Zuraini Ismail ◽  
Ummi Rabaah Hashim ◽  
Nor Haslinda Ismail ◽  
Raja Rina Raja Ikram ◽  
...  
Keyword(s):  
Information Systems ◽  
Improve Patient Safety ◽  
Structured Interview ◽  
Hospital Information Systems ◽  
Healthcare Practitioner ◽  
Resultant Data ◽  
Quality Of Patient Care ◽  
Copy And Paste ◽  
Improve Patient

This study aims to investigate healthcare practitioner behaviour in adopting Health Information Systems which could affect patients’ safety and quality of health. A qualitative study was conducted based on a semi-structured interview protocol on 31 medical doctors in three Malaysian government hospitals implementing the Total Hospital Information Systems. The period of study was between March and May 2015. A thematic qualitative analysis was performed on the resultant data to categorize them into relevant themes. Four themes emerged as healthcare practitioners’ behaviours that influence the unsafe use of Hospital Information Systems. The themes include (1) carelessness, (2) workarounds, (3) noncompliance to procedure, and (4) copy and paste habit. By addressing these behaviours, the hospital management could further improve patient safety and the quality of patient care.

Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals

2018 ◽  
Vol 25 (4) ◽  
pp. 1358-1372 ◽  
Author(s):  
Lizawati Salahuddin ◽  
Zuraini Ismail ◽  
Ummi Rabaah Hashim ◽  
Raja Rina Raja Ikram ◽  
Nor Haslinda Ismail ◽  
...  
Keyword(s):  
Information System ◽  
Information Systems ◽  
Hospital Information System ◽  
Hospital Information Systems ◽  
System Quality ◽  
Structured Interviews ◽  
Factors Influencing ◽  
Resultant Data ◽  
Government Hospitals ◽  
Malaysian Government

The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

scholarly journals A prospective closed loop audit on the quality of the operative notes in a general surgical unit in a quaternary care centre

2020 ◽  
Vol 7 (2) ◽  
pp. 382 ◽  
Author(s):  
Mohamed Javid ◽  
Shanthi Ponnandai Swaminathan ◽  
Arun Victor Jebasingh ◽  
Manivannan Velayutham ◽  
Rajeswari Mani
Keyword(s):  
Clinical Audit ◽  
Improve Patient Safety ◽  
Care Hospital ◽  
Prospective Audit ◽  
Surgical Practice ◽  
Standards Of Practice ◽  
Operative Notes ◽  
Improve Patient ◽  
Surgical Unit

Background: Proper documentation of the surgery done in the form of operative notes is a very important aspect of surgical practice. The aim of this clinical audit was to identify the existing standard of the operative notes written in a general surgical unit in a quaternary care hospital; and to compare it with the recommendations given by Royal College of Surgeons, England (in Good Surgical Practice, 2014) and if needed, to improve the standard of practice.Methods: In the first loop of this prospective audit, 75 consecutive operative notes which were written were compared with the RCS guidelines and the areas which had missing data were identified. These areas were informed to the residents, who are primarily involved in the documentation of the operative notes. The second loop of the audit was conducted after a gap of 4 months involving 75 consecutive operative notes again.Results: The areas which were initially deficient were better documented when analysed in the second loop.Conclusions: Documentation of operative notes does not always comply with the set guidelines as highlighted in the first loop of our audit. But by employing a clinical audit it is possible to identify the existing deficiencies and thereby improving the standards of practice. Also, operative note writing should be taught as part of surgical training. Definitions should be clearly provided, and specific guidelines should be established to improve the quality of the operative notes and their use to improve patient safety.

scholarly journals Criteria for Ethical Evaluation of Hospital Information Systems: A Protocol for Systematic Review

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Hamid Reza Dehghan ◽  
Saeed Eslami ◽  
Mahdieh Namayandeh ◽  
Arezo Dehghani ◽  
Saeed Hajian Dashtaki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Information Technology ◽  
Information Systems ◽  
Ethical Issues ◽  
Hospital Information Systems ◽  
Cochrane Library ◽  
Policy Makers ◽  
Ethical Evaluation ◽  
Medical Databases

Introduction: The implementation of information technology is an important factor in improving the quality of patient care. Since a hospital is an organization that needs effective management of information, the implementation of information technology is necessary for improving the ef ciency of the services, quality of care, and reducing the costs. Ethical evaluation of hospital information systems is one of the existing gaps in evaluating this technology. Many evaluations have been carried out for information that is more technical and not concerned with ethical issues. Therefore, this study aims to compile a checklist for the evaluation of ethical dimensions of this technology using a systematic review. Methods: We searched international medical databases, such as the U.K. Centre for Reviews and Dissemination, MEDLINE/PubMed, and Cochrane Library; Iranian databases Irandoc, Iranmedex, Medlib, SID, and grayscale websites SInGLE, and Ideas.recp. After selecting the studies based on inclusion and exclusion criteria, two experts in the eld of information technology and ethical evaluation extract ethical issues from the full text of the articles. Results and Dissemination: The results of the study will be published in a peer-reviewed journal and presented at relevant conferences, which can be used by policy makers and healthcare decision-makers.

scholarly journals Technovigilance and risk management as tools to improve patient safety in Colombian health care institutions

2017 ◽  
Vol 11 (21) ◽  
Author(s):  
Andrés Mauricio González Vargas ◽  
Ana María Sánchez Benavides ◽  
Andrés Felipe Betancourt Hernández ◽  
Carlos David Mantilla Ramirez
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Patient Safety ◽  
Health Services ◽  
Improve Patient Safety ◽  
Health Care Institutions ◽  
Improve Patient

This paper presents the results of a survey about technovigilance carried out in 21 clinical institutions from the southwest of Colombia. It also provides an analysis of how these programs take into account different risk management methodologies in order to create awareness of the importance of patient safety in all members of the staff and improve the quality of the health services provided.

scholarly journals THE USAGE OF MEDICAL INFORMATICS IN CRITICAL CARE MEDICINE

2017 ◽  
Vol 1 (4) ◽  
pp. 100-101
Author(s):  
Marsa Gholamzadeh ◽  
Hamidreza Abtahi
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Decision Support ◽  
Information Systems ◽  
Medical Informatics ◽  
Clinical Information ◽  
Clinical Information Systems ◽  
Quality Of Patient Care ◽  
The World

Introduction: The intensive care unit can be defined as a complex system that composed of clinical informations, tasks and knowledge. It is also one of the most stressful and most vital parts of healthcare centers which involve a huge amount of information and clinical data daily. These informations should be analyzed and managed in the best way as soon as possible to restore patients to normal by health professionals. Accurate and timely diagnosis, the best treatment and to avoid any possible error in this section can be equivalent to achieve the best possible result and reducing the length of hospitalization and mortality. As a result, due to the complex nature of the critical care and the mass of clinical data; using a combination of medical knowledge with the latest technologies and use of medical informatics capabilities can be the best way to reduce the workload of the sector and improve the quality of patient care. Methods: A systematic search was conducted on the PubMed/MEDLINE, web of science, BMJ, ScienceDirect, and Scopus database for finding studies that have related to critical care and usage of informatics or medical informatics. The collected data and results are summarized by researchers and the results analyzed based on similarities and differences. Results: With increased development of medical informatics and electronic systems has led to substantial progress in the field of critical care since 1980 till now around the world. Several articles, research projects has published. From 1981 to 2016 almost 600 scientific papers were found which included reports, posters and thesis written in context of critical care medical informatics. More than 65 percent of these studies is about designing CDSS in this field. Today, many of these systems are used in medical centers around the world and lead to improving the quality of patient care and reduce medical errors in intensive care units. Among these 600 papers, 230 articles related to our issue in fields of the design of electronic records, clinical information systems, decision support systems, data mining, telemedicine, smart analysis of clinical information and knowledge extraction techniques were selected as the main source of this study. Conclusion: According to results of our study, it seems that critical care is potentially a valuable resource for medical informatics researches. The applied of medical informatics in the different fields of the diagnosis, interpretation, and treatment in different countries have improved the quality of care for patients in critical care field. We can mention some common fields which used such as infection control and early detection in intensive care units, clinical information systems, and CPOE and decision support systems such as APACHE system for grading the severity of illness of patients who hospitalized and even telemedicine. Since this area of research has not been a field of interest in Iran yet, it seems that this study with the aim of review the application of medical informatics in different countries could lead to practical researches in this field.

scholarly journals Implementing Black Box Warnings (BBWs) in Health Information Systems

2012 ◽  
Vol 03 (01) ◽  
pp. 124-134 ◽  
Author(s):  
E. Yang ◽  
A. Daghstani ◽  
D. C. Kaelber ◽  
M. Ikezuagu
Keyword(s):  
Information Systems ◽  
Health Information ◽  
Improve Patient Safety ◽  
Health Information Systems ◽  
Clinical Decision ◽  
Black Box ◽  
Third Parties ◽  
Black Box Warnings ◽  
Types Of Information ◽  
Improve Patient

SummaryObjective: To develop a practical approach for implementing clinical decision support (CDS) for medication black box warnings (BBWs) into health information systems (HIS).Methods: We reviewed all existing medication BBWs and organized them into a taxonomy that identifies opportunities and challenges for implementing CDS for BBWs into HIS.Results: Of the over 400 BBWs that currently exist, they can be organized into 4 categories with 9 sub-categories based on the types of information contained in the BBWs, who should be notified, and potential actions to that could be taken by the person receiving the BBW. Informatics oriented categories and sub-categories of BBWs include – interactions (13%) (drug-drug (4%) and drug-diagnosis (9%)), testing (21%) (baseline (9%) and on-going (12%)), notifications (29%) (drug prescribers (7%), drug dispensers (2%), drug administrators (9%), patients (10%), and third parties (1%)), and non-actionable (37%). This categorization helps identify BBWs for which CDS can be easily implemented into HIS today (such as drug-drug interaction BBWs), those that cannot be easily implemented into HIS today (such as non-actionable BBWs), and those where advanced and/ or integrated HIS need to be in place to implement CDS for BBWs (such a drug dispensers BBWs).Conclusions: HIS have the potential to improve patient safety by implementing CDS for BBWs. A key to building CDS for BBWs into HIS is developing a taxonomy to serve as an organizing roadmap for implementation. The informatics oriented BBWs taxonomy presented here identified types of BBWs in which CDS can be implemented easily into HIS currently (a minority of the BBWs) and those types of BBWs where CDS cannot be easily implemented today (a majority of BBWs).

scholarly journals Hospital Information Systems (HIS) in the Examination Rooms and Wards: Doctors Perceived Positive Impact on Quality of Care and Patient Safety

2018 ◽  
Vol 7 (2.29) ◽  
pp. 871 ◽  
Author(s):  
Lizawati Salahuddin ◽  
Zuraini Ismail ◽  
. .
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Information Systems ◽  
Positive Impact ◽  
Healthcare Services ◽  
Hospital Information Systems ◽  
Structured Interviews ◽  
Healthcare Organizations ◽  
The Impact

Hospital Information Systems [HIS] is developed to support healthcare organizations in providing efficient, quality, and safe healthcare services. The objective of this study is to identify and describe doctors’ perspective on the impact of HIS use in the examination rooms and wards on quality of care and patient safety. Semi-structured interviews were carried out with thirty one doctors from three Malaysian government hospitals. Thematic qualitative analysis was performed by using ATLAS.ti to deduce the relevant themes. HIS were commonly believed to improve quality of care and patient safety in terms of : [1] accessibility of patients’ record, [2] efficient patient-care, [3] well-structured report viewing, [4] less missing patients’ records, [5] legibility of patients’ records, and [6] safety features. In conclusion, the use of HIS in examination rooms and wards suggests to improve the quality of care and patient safety.  

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