Regional Patient Safety Initiatives: The Missing Element of Organizational Change

Regional Patient Safety Initiatives: The Missing Element of Organizational Change

James G. Anderson (Purdue University, USA)
DOI: 10.4018/978-1-59904-792-8.ch010
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Data-sharing systems—where healthcare providers jointly implement a common reporting system to promote voluntary reporting, information sharing, and learning—are emerging as an important regional, state-level, and national strategy for improving patient safety. The objective of this chapter is to review the evidence regarding the effectiveness of these data-sharing systems and to report on the results of an analysis of data from the Pittsburgh Regional Healthcare Initiative (PRHI). PRHI consists of 42 hospitals, purchasers, and insurers in southwestern Pennsylvania that implemented Medmarx, an online medication error reporting systems. Analysis of data from the PRHI hospitals indicated that the number of errors and corrective actions reported initially varied widely with organizational characteristics such as hospital size, JCAHO accreditation score and teaching status. But the subsequent trends in reporting errors and reporting actions were different. Whereas the number of reported errors increased significantly, and at similar rates, across the participating hospitals, the number of corrective actions reported per error remained mostly unchanged over the 12-month period. A computer simulation model was developed to explore organizational changes designed to improve patient safety. Four interventions were simulated involving the implementation of computerized physician order entry, decision support systems and a clinical pharmacist on hospital rounds. The results of this study carry implications for the design and assessment of data-sharing systems. Improvements in patient safety require more than voluntary reporting and clinical initiatives. Organizational changes are essential in order to significantly reduce medical errors and adverse events.

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Table of Contents
Steven A. Huesing
Chapter 1
Andre W. Kushniruk, Elizabeth M. Borycki, Shige Kuwata, Francis Ho
It is essential that health information systems are easy to use, meet user information needs and are shown to be safe. However, there are currently... Sample PDF
Emerging Approaches to Evaluating the Usability of Health Information Systems
Chapter 2
Morgan Price
The purpose of this chapter is to provide the reader with an overview of several models and theories from the general HCI literature, highlighting... Sample PDF
A Bio-Psycho-Social Review of Usability Methods and their Applications in Healthcare
Chapter 3
Craig E. Kuziemsky
The design and implementation of healthcare information systems (HIS) is problematic as many HIS projects do not achieve the desired outcomes. There... Sample PDF
Enhancing ‘Fit' of Health Information Systems Design Through Practice Support
Chapter 4
Christian Nøhr, Niels Boye
The introduction of electronic health records (EHRs) to the clinical setting has led healthcare professionals, policy makers, and administrators to... Sample PDF
Towards Computer Supported Clinical Activity: A Roadmap Based on Empirical Knowledge and some Theoretical Reflections
Chapter 5
Niels Boye
Pervasive healthcare is a vision for the future of healthcare. Healthcare provisions can be delivered with high quality at low cost along with... Sample PDF
Pervasive Healthcare: Problems and Potentials
Chapter 6
Karen Day, Tony Norris
In this chapter we describe the transition phase (capability crisis) of the change process linked to health IT projects, indicate how it can be... Sample PDF
The Human Aspects of Change in IT Projects
Chapter 7
Beste Kucukyazici, Karim Keshavjee, John Bosomworth, John Copen, James Lai
This chapter introduces a multi-level, multi-dimensional meta-framework for successful implementations of EHR in healthcare organizations. Existing... Sample PDF
Best Practices for Implementing Electronic Health Records and Information Systems
Chapter 8
Vivian Vimarlund
This chapter introduces a framework to analyze the pre-requisites to move from an evolutionary stage to a revolutionary one when using ICT in... Sample PDF
Health Informatics and Healthcare Redesign Using ICT to Move from an Evolutionary to a Revolutionary Stage
Chapter 9
Elizabeth M. Borycki, Andre W. Kushniruk
Borycki, Elizabeth M.; Kushniruk, Andre W. Health information technology has the potential to greatly improve healthcare delivery. Indeed, in recent... Sample PDF
Where do Technology-Induced Errors Come From? Towards a Model for Conceptualizing and Diagnosing Errors Caused by Technology
Chapter 10
James G. Anderson
Data-sharing systems—where healthcare providers jointly implement a common reporting system to promote voluntary reporting, information sharing, and... Sample PDF
Regional Patient Safety Initiatives: The Missing Element of Organizational Change
Chapter 11
Jytte Brender
This chapter discusses the extent to which factors known to influence the success and failure of health information systems may be evaluated. More... Sample PDF
Evaluation Methods to Monitor Success and Failure Factors in Health Information System's Development
Chapter 12
Denis Protti
Healthcare is one of the world’s most information-intensive industries. Every day, volumes of data are produced which, properly used, can improve... Sample PDF
A Comparison of How Canada, England, and Denmark are Managing their Electronic Health Record Journeys
Chapter 13
Joseph L. Kannry
Healthcare IT (HIT) has failed to live up to its promise in the United States. HIT solutions and decisions need to be evidence based and... Sample PDF
Operationalizing the Science: Integrating Clinical Informatics into the Daily Operations of the Medical Center
Chapter 14
Eric L. Eisenstein, Maqui Ortiz, Kevin J. Anstrom, David F. Lobach
This chapter describes a framework for conducting economic analyses of health information technologies (HIT). It explains the basic principles of... Sample PDF
Health Information Technology Economic Evaluation
Chapter 15
Nola M. Ries
This chapter discusses key legal issues raised by the contemporary trend to managing and sharing patient information via electronic health records... Sample PDF
Legal Issues in Health Information and Electronic Health Records
Chapter 16
Tina Saryeddine
Existing literature often addresses the ethical problems posed by health informatics. Instead of this problem-based approach, this chapter explores... Sample PDF
Accountability, Beneficence, and Self-Determination: Can Health Information Systems Make Organizations “Nicer”?
Chapter 17
Eike-Henner W. Kluge
The development of electronic health records marked a fundamental change in the ethical and legal status of health records and in the relationship... Sample PDF
Electronic Health Records: Why Does Ethics Count?
Chapter 18
Kendall Ho
Because of the rapid growth of health evidence and knowledge generated through research, and growing complexity of the health system, clinical care... Sample PDF
Technology Enabled Knowledge Translation: Using Information and Communications Technologies to Accelerate Evidence Based Health Practices
Chapter 19
Diane Doran, Tammie Di Pietro
With advances in electronic health record systems and mobile computing technologies it is possible to re-conceptualize how health professionals... Sample PDF
Knowledge Translation in Nursing Through Decision Support at the Point of Care
Chapter 20
Jose F. Arocha, Laurie Hoffman-Goetz
This chapter presents a discussion and findings of health literacy and its relevance to health informatics. We argue that the Internet represents an... Sample PDF
Improving Internet-Based Health Knowledge Through Attention to Literacy
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