Research Unit of Health Sciences and Technology, University of Oulu, Finland; Oulu University of Applied Sciences, Oulu, Finland.
Oulu University Hospital, Nursing Administration, Oulu, Finland.
Int J Med Inform. 2023 Jun;174:105045. doi: 10.1016/j.ijmedinf.2023.105045. Epub 2023 Mar 17.
The current literature related to patient safety of interorganizational health information is fragmented. This study aims to identify interorganizational health information exchange-related patient safety incidents occurring in the emergency department, emergency medical services, and home care. The research also aimed to describe the causes and consequences of these incidents.
A total of sixty (n = 60) interorganizational health information exchange-related patient safety incident free text reports were analyzed. The reports were reported in the emergency department, emergency medical services, or home care between January 2016 and December 2019 in one hospital district in Finland.
The identified interorganizational health information exchange-related incidents were grouped under two main categories: "Inadequate documentation"; and "Inadequate use of information". The causes of these incidents were grouped under the two main categories "Factors related to the healthcare professional " and "Organizational factors", while the consequences of these incidents fell under the two main categories "Adverse events" and "Additional actions to prevent, avoid, and correct adverse events".
This study shows that the inadequate documentation and use of information is mainly caused by factors related to the healthcare professional and organization, including technical problems. These incidents cause adverse events and additional actions to prevent, avoid, and correct the events. The sociotechnical perspective, including factors related to health care professionals, organization, and technology, should be emphasized in patient safety development of inter-organizational health information exchange and it will be the focus of our future research. Continuous research and development work is needed because the processes and information systems used in health care are constantly evolving.
目前有关组织间卫生信息患者安全的文献较为分散。本研究旨在确定发生在急诊科、急救医疗服务和家庭护理中的与组织间卫生信息交换相关的患者安全事件。研究还旨在描述这些事件的原因和后果。
共分析了 60 份与组织间卫生信息交换相关的患者安全事件无文本报告。这些报告是在 2016 年 1 月至 2019 年 12 月期间在芬兰的一个医院区的急诊科、急救医疗服务或家庭护理中报告的。
确定的与组织间卫生信息交换相关的事件分为两大类：“文档记录不充分”和“信息使用不当”。这些事件的原因分为“与医护人员相关的因素”和“组织因素”这两个主要类别，而这些事件的后果则分为“不良事件”和“采取额外措施以预防、避免和纠正不良事件”这两个主要类别。
本研究表明，文档记录和信息使用不充分主要是由与医护人员和组织相关的因素以及技术问题引起的。这些事件会导致不良事件以及采取额外措施以预防、避免和纠正事件。在组织间卫生信息交换的患者安全发展中，应强调包括医护人员、组织和技术相关因素的社会技术视角，这将是我们未来研究的重点。由于医疗保健中使用的流程和信息系统在不断发展，因此需要持续的研究和开发工作。
