2020 Fiscal Year Research-status Report
Patient safety: Casting a spotlight on electronic medical record-related incidents
| Project/Area Number |
19K15236
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| Research Institution | Tokyo Institute of Technology |
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Principal Investigator |
顧 秀珠 東京工業大学, 工学院, 准教授 (20632615)
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| Project Period (FY) |
2019-04-01 – 2022-03-31
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| Keywords | Patient safety / Incident / EMR system / Taxonomy |
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| Outline of Annual Research Achievements |
In FY 2019, a taxonomy system for electronic medical record (EMR)-related incident analysis has been developed. Particularly, this taxonomy system payed more attention on interaction failures between healthcare staff and EMR systems, as most of previous studies focused on technology errors. Then in FY 2020, incident records related to EMR were collected from several hospitals. The developed taxonomy system for EMR-related incident analysis were applied to the collected incidents. Results showed that the frequent failures were for instance because of healthcare staff's wrong input, missing input and lacking of data check (patient data in EMR). Latent factors behind these failures included insufficient training, interruptions, varied culture between different units/departments, etc.
Using patient handoff as an example, after adoption of EMR, handoffs between different units/departments (inter-unit handoff) were conducted better that information was more sufficiently transferred. In addition, healthcare providers perceived less conflict views about what information was necessary to transfer in patient handoffs. However, situation was different for shift handoffs. After the adoption of EMR, information was transferred better between shifts only in surgery unit. And for both inter-unit handoffs and shift handoffs, efficiency had no significant improvement.
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| Current Status of Research Progress |
Current Status of Research Progress
3: Progress in research has been slightly delayed.
Reason
The progress of the project is delayed because of COVID-19. Based on the plan, in FY 2020, first is to collect EMR-related incident records from several hospitals that has been conducted. However, very few incidents were reported by healthcare staff as expected. And the information included in the incident reports were not sufficient. Thus, based on the plan, to collect more information of errors related to EMR systems, observations were planned to different EMR users such as physicians and nurses. However, due to COVID-19, no hospital would like to participate in the observation experiment. Therefore, the developed taxonomy system has been only applied to the collected incident records. Thus, characteristics of EMR-related incidents in the current context of Japanese hospitals was somehow explored but not sufficient. Based on the plan of FY 2020, to confirm the results obtained from taxonomy analysis, a questionnaire survey was planned to be conducted to healthcare staff about their perspectives of EMR-related incidents such as frequency and severity of each type of errors, and latent factors contributing to these errors. This survey is still ongoing that has not been finished yet.
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| Strategy for Future Research Activity |
Due to COVID-19, the observation experiment may be cancelled considering the risks. However, the questionnaire survey to healthcare staff is stilled ongoing and hopefully could be finished successfully. The other plans in FY2021 are as follows: (1) To develop an EMR-related incident management system. First, EMR-related patient safety management experience will be learned from EMR advanced countries. Based on all the results obtained, an EMR-related incident management system will be developed. It includes incident reporting, i.e., what kind of incidents should be reported, to what extent and how. A common format for EMR-related incident reporting will be designed. The system also includes how to make analysis of incidents; corresponding to the analysis results, what kind of measures could be taken and how, and how to make evaluations after taking measures. (2) To implement the EMR-related incident management system and validate its effectiveness. The developed system will be implemented after adaptation to the current hospital systems. Effectiveness of the system will be verified after implementation, using indicators such as change of EMR-related incident reporting rate, appropriateness of proposed measures, and healthcare staff and risk managers’ satisfaction.
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| Causes of Carryover |
First, computer-related consumables such as paper and toners of printer are needed. Accordingly, costs for these expendables are included in the budget. As information and records will be obtained from hospitals, to those who cooperated in providing information, remunerations are needed for their contributions. Then, two graduate students are required assisting in questionnaire survey, data analysis and preparation of reports. Thus, costs are needed for RA remunerations. In addition, for the survey, costs for questionnaire copies and post are necessary. As various data is collected, statistical analysis should be performed by software such as SPSS and AMOS. To disseminate the results to the society and to gain experience and advice from international researchers, attending international conferences and making research discussions with foreign scholars are crucial. Therefore, registration fees of the international conferences are included in the budget plan.
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Research Products
(5 results)
