Patient safety hazards resulting from information technology usage in outpatient oncology infusion centers

The aim of the present study from Dr. Yvonne Pfeiffer, Chantal Zimmrmann and Prof. Dr. David Schwappach from Patient Safety Switzerland was to identify patient safety hazards coming with the use of health information technology (HIT): patient safety hazards in three outpatient oncology infusion centers were assessed and priority topics identified.

Additionally, the number of information sources clinicians have to use in order to get an idea of the patient's situation was systematically assessed. Interviews and observations were conducted with one nurse and one doctor of each ambulatory infusion center.

Principal results
Information management-related patient safety hazards were omnipresent in daily care: eleven topics were identified from 125 assessed patient safety hazards. Three of them were particularly relevant to the clinicians’ development of an adequate mental model about the patient: patient-related information was not stored in one place but often fragmented in different HIT systems; despite the introduction of HIT, paper documentation remained in place for certain information, making access difficult and increasing the number of relevant sources; the lack of usability of the HIT systems made it difficult to retrieve patient information in a timely manner. Clinicians needed to use between 5 and 11 sources of information to get a more complete picture of a patient's situation.

Major conclusions
Overall, it has been shown that the design of the HIT systems is not sufficiently adapted to the work processes and does not support clinicians in being fully informed about a patient. The topics identified point to future system design and areas for improvement. In this process, it is very important to align the real work requirements with the design of the HIT and to evaluate and monitor the actual implementation and use of HIT.

Source: ZEFQ Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen

Authors: Dr. Yvonne Pfeiffer, Chantal Zimmermann, Prof. Dr. David Schwappach, Fondation sécurité des patients suisse