eQuality and eSafety Program, Provincial Patient Safety, Alberta Health Services, Edmonton, Alberta, Canada.
Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Appl Clin Inform. 2023 Aug;14(4):735-742. doi: 10.1055/s-0043-1771392. Epub 2023 Sep 13.
According to Digital Health Canada 2013 eSafety Guidelines, an estimated one-third of patient safety incidents following implementation of clinical information systems (CISs) are technology-related. An eSafety checklist was previously developed to improve CIS safety by providing a comprehensive listing of system-agnostic, evidence-based configuration recommendations.
We sought to use the checklist to support safe initial configuration of a provincial system-wide CIS (Alberta, Canada), referred to as Connect Care.
The checklist was applied to 13 Connect Care modules in three successive phases. First, the checklist was adapted to an abbreviated high-priority version. Second, demonstrations of each module were recorded. Finally, independent evaluation of each recording was conducted by two eSafety evaluators using the abbreviated eSafety checklist.
All modules achieved greater than 72% compliance, with an average of 84%. Overall, 273 opportunities for improvement were identified, with four major areas or themes emerging: (1) inconsistent date and time, (2) unclear patient identification, (3) ineffective alert system, and (4) insufficient decision support. These opportunities were forwarded to the appropriate build teams for review and implementation.
This work is the first to utilize the eSafety checklist in a real-world CIS, which will become one of the largest in Canada. The checklist has shown clinical applicability in identifying gaps in CIS configuration and should be considered for use in future and pre-existing CISs.
根据 2013 年加拿大数字健康电子安全指南，在实施临床信息系统 (CIS) 后，估计有三分之一的患者安全事件与技术相关。之前开发了一份电子安全检查表，通过提供系统无关的、基于证据的配置建议的综合清单，以提高 CIS 安全性。
我们试图使用该检查表来支持全省范围内的 CIS（加拿大艾伯塔省）的安全初始配置，该系统称为 Connect Care。
检查表分三个连续阶段应用于 13 个 Connect Care 模块。首先，检查表被改编为简短的高优先级版本。其次，记录了每个模块的演示。最后，两名电子安全评估员使用简短的电子安全检查表对每个记录进行独立评估。
所有模块的合规性均超过 72%，平均为 84%。总体而言，确定了 273 个改进机会，出现了四个主要领域或主题：（1）不一致的日期和时间，（2）不明确的患者身份，（3）无效的警报系统，（4）决策支持不足。这些机会被转发给相应的构建团队进行审查和实施。
这项工作是首次在实际 CIS 中使用电子安全检查表，这将成为加拿大最大的 CIS 之一。检查表已显示出在识别 CIS 配置中的差距方面具有临床适用性，应考虑在未来和现有 CIS 中使用。
