JMIR Publications

ABSTRACT

Background:

While intended to support improvement, the rapid adoption and evolution of technologies in healthcare can also bring about unintended consequences related to safety. In this project an embedded researcher with expertise in patient safety and clinical education worked with a clinical informatics team to examine safety and harm related to health information technologies in primary and community care settings. The clinical informatics team participated in learning activities around relevant topics (e.g., human factors, high reliability organisations, sociotechnical systems) and co-created a process to address safety events related to technology (i.e., safety huddles and sociotechnical analysis of safety events).

Objective:

The aim of this study was to explore clinical informaticians’ experiences in incorporating safety practices into their work.

Methods:

A qualitative descriptive design was used and online focus groups were conducted with clinical informaticians. Thematic analysis was used to analyze the data.

Results:

Ten informants participated. Barriers to addressing safety and harm in their context included limited prior knowledge of health information technology safety, previous assumptions and perspectives, competing priorities and organizational barriers, difficulty with reporting system and processes, and a limited number of reports for learning. Enablers to promoting safety and mitigating harm included participating in learning sessions, gaining experience analyzing reported events, participating in safety huddles, and role modelling and leadership from the embedded researcher. Individual outcomes included increased ownership and interest in health information technology safety, development of a sociotechnical systems perspective, thinking differently about safety, and increased consideration for user perspectives. Team outcomes included enhanced communication within the team, using safety events to inform future work and strategic planning, and an overall promotion of a culture of safety.

Conclusions:

As health information technologies are integrated into care delivery, it is important for clinical informaticians to recognize the risks related to safety. Experiential learning activities, including reviewing safety event reports and participating in safety huddles, were identified as particularly impactful. A health information technology safety learning initiative is a feasible approach for clinical informaticians to become more knowledgeable and engaged in health information technology safety issues in their work.