Search results for "Electronic Health Records"

Adverse events after hospital discharge are common. Prior research demonstrates that communication and information transfer between inpatient providers and primary care physicians (PCPs) may be lacking, raising patient safety concerns. This study described how applying Lean methodology, enhancing frontline provider engagement, and redesigning workflow processes within the electronic health record led to improved communication with PCPs around the time of hospital discharge. Through these interventions, the pediatric medical service was able to increase verbal communication with PCPs at discharge to 80%, and they sustained this for a 7-month period. Discharge communication with PCPs across other services improved as well. A previous PSNet perspective discussed the challenges associated with care transitions and suggested opportunities for improvement.

Although computerized provider order entry (CPOE) for medications has reduced medication errors, it has also had unintended consequences. This simulation study used the validated Leapfrog evaluation tool to assess the safety of CPOE for medications for pediatric patients across multiple electronic health record (EHR) platforms. The investigators had clinicians familiar with the EHR enter prespecified unsafe orders into simulated patient records and note whether alerts or messages ensued. As demonstrated in prior work, many potentially unsafe medication orders did not lead to alerts. The authors report that repeated use of the tool led to improvement over time, which suggests the need for regular safety testing for EHRs after implementation.

This study found that parents of hospitalized children used the Internet-based patient portal and reported high rates of satisfaction. Parents perceived that the portal would reduce medical errors. This work suggests that engaging patients and caregivers via health-related Internet activities could support safe inpatient care.

The I-PASS standardized handoff protocol is considered the gold standard for inpatient handoffs, having been shown to reduce adverse events among hospitalized patients. In this study, implementation of I-PASS within an electronic medical record resulted in an improvement in handoff quality among pediatric residents. A recent PSNet interview discussed handoffs and the implementation and findings of the landmark I-PASS study.

This study highlights the slow adoption of electronic health records in children's hospitals, with less than 3% having a comprehensive system in place. Hospital characteristics were not associated with implementation, and financing was the most important policy strategy identified to promote use.

Patient handoffs are vulnerable to errors of omission. This quality improvement project designed and implemented a checklist as a way to standardize the process of pediatric handoffs. The program found the tool to be effective in uncovering problems and physicians felt the checklist supported situational awareness and patient safety.

This study compared an outpatient pediatric clinic with pharmacist prescription medication review and electronic health record customization to one without such systems in place. The clinic with workflow and technology to prevent adverse drug events experienced fewer errors, adding to the evidence that sociotechnical approaches are needed to improve medication safety.

This commentary describes human factors, usability, and informatics recommendations for electronic health records in pediatrics to improve their usefulness and reduce the risk of errors.

Medication reconciliation is necessary to reduce preventable medication errors, but despite much research, no consensus exists on how the process should be performed in either the inpatient or outpatient setting. This study, conducted at a children's hospital, demonstrates how accurate medication reconciliation can be achieved through establishing a culture of safety and rigorously applying quality improvement principles. Although the hospital had an existing electronic health record and computerized provider order entry system, a reliable medication reconciliation process was not achieved until existing processes were thoroughly analyzed, failure modes were determined, and rapid cycle tests of change were conducted. As medication reconciliation will be reinstated as a National Patient Safety Goal in July 2011, this article provides a useful blueprint for organizations tackling this difficult problem.

This study examined the utility of a multimedia kiosk to capture parents' knowledge of their children's asthma medication history. Investigators compared the parental information with that documented by emergency department providers. Results suggested greatest accuracy in medication name followed by route of delivery, form of medication, and dose. The authors conclude that patient-derived data can be effective in improving current deficits in medication documentation during emergency department visits.