SAFER Guides and Evaluating Technology Usage
As healthcare continues to embrace technological advancements, healthcare professionals must thoroughly understand the potential risks of implementing these technologies. This is especially critical for Doctor of Nursing Practice (DNP) nurses who may find themselves leading large-scale informatics implementation projects. Identifying and mitigating potential risks is critical to ensuring the safety and integrity of patient data in healthcare settings (Scantlebury et al., 2021).
We will examine the use of these guides to evaluate the implementation of an electronic health record (EHR) system as a solution for addressing safety, process, or quality issues in a chosen healthcare context, i.e., Allen hospital (Aguirre et al., 2019). The findings from this evaluation will inform the development of a risk mitigation plan in a later assessment. Using the SAFER guides, DNP nurses can comprehensively understand the potential risks of implementing informatics solutions in healthcare (Flaubert et al., 2021). This knowledge is critical for ensuring patient safety and data integrity and for the success of informatics implementation projects. This paper will explore using the SAFER guides to identify performance and risk issues in healthcare settings.
EHR as a Practice Change to Drive Improvements
An electronic health record (EHR) is a proposed informatics solution implemented as part of a practice change to drive improvements in the chosen healthcare environment (Tsai et al., 2020). The EHR system will replace the paper-based record-keeping system with a digital platform enabling healthcare providers to access patient information from a centralized location. The EHR system will capture and store patient information such as medical history, diagnoses, medications, allergies, laboratory test results, and radiology reports.
The primary goal of implementing an EHR system is to improve patient care and outcomes by providing healthcare providers with easy access to accurate, up-to-date patient information (Adane et al., 2019). This will help to ensure that healthcare providers can make well-informed decisions about patient care, reducing the likelihood of errors and improving patient safety. Additionally, the EHR system will streamline administrative processes such as billing and scheduling, reducing the time and resources required for these tasks. Other improvement goals include increasing efficiency, reducing costs, enhancing communication, and improving patient satisfaction.
SAFER Guide Findings Related to Good Performance
The SAFER Guides evaluation of Allen Hospital’s EHR implementation has identified several areas where the hospital performs well. One of the areas where Allen Hospital is performing well is in the Hardware and Software Dependability domain. The hospital has implemented robust hardware, and software systems that are dependable, stable, and secure, which helps to ensure that patient data is protected and available when needed (Szarfman et al., 2022). The hospital has also implemented several measures to ensure the reliability of hardware and software systems, such as regular system backups and failover systems.
Another area where Allen Hospital is performing well is in the Contingency Planning domain. The hospital has established robust contingency plans to ensure that patient data is protected and available during a disaster or system failure (Melnychuk et al., 2022). The hospital has also established procedures for regular data backups and recovery to ensure that patient data is not lost during a system failure (Melnychuk et al., 2022).
In addition, the hospital is performing well in the Clinical Process Improvement domain. The hospital has implemented several measures to improve clinical processes, such as using clinical decision-support tools and integrating clinical guidelines into the EHR system (Enticott et al., 2021). This has helped improve the quality of patient care, reduce errors, and improve patient outcomes.
Examples
For example, during the SAFER Guides evaluation, it was found that Allen Hospital has implemented several measures to ensure that the EHR system is dependable and secure. For instance, the hospital has implemented a robust backup system, ensuring that patient data is backed up regularly and available in case of a system failure. The hospital has also implemented a failover system that ensures that the EHR system remains available in case of a hardware or software failure. Furthermore, the hospital has implemented clinical decision support tools, such as alerts and reminders, which have helped improve patient care quality. For instance, the EHR system alerts clinicians when patients are due for preventive services, such as cancer screenings and immunizations, which has helped to improve patient outcomes (Huffstetler et al., 2022).
SAFER Guide Findings related to risks
Based on the SAFER Guides evaluation of Allen Hospital’s proposed implementation of an EHR, several risks were identified that could potentially impact the project’s success. These risks are categorized under various SAFER components, including Hardware & Software Resilience, Contingency Planning, System Interfaces, Patient Identification, Clinical Workflow, and Communications. Below are examples of specific risks identified in each of these components.
Examples
The SAFER Guides used to evaluate the proposed Electronic Health Record (EHR) system at Allen Hospital highlighted several risks that must be addressed for successful implementation. The first area of concern identified by the SAFER Guides was the hospital’s IT infrastructure’s ability to support the new EHR system, which could lead to system downtime and data loss (Keshta & Odeh, 2020). The EHR system may also require significant hardware upgrades to meet the system requirements. Another risk identified by the SAFER Guides was the need for a robust contingency plan in case of system failure or data loss (McGowan et al., 2022). The hospital may need to invest in a backup and recovery system to ensure that data is not lost in case of a disaster.
The SAFER Guides also revealed that the new EHR system might need to interface better with other systems used by the hospital, such as the laboratory information system or the pharmacy system. This could lead to data consistency and errors (Khubone et al., 2020). In addition, the Guides highlighted the need for a reliable patient identification system to avoid patient data being assigned to the wrong record. The new EHR system may require significant changes to the clinical workflow at Allen Hospital, requiring staff training on new workflows and ensuring that the EHR system runs smoothly with existing clinical workflows. Finally, the SAFER Guides identified the need for new communication channels between clinicians, staff, and patients, which should be reliable and secure to avoid data breaches and communication errors (Das et al., 2020). These findings reveal that Allen Hospital needs to develop robust hardware and software resilience, contingency planning, patient identification systems, and communication channels to support the successful implementation of the proposed EHR system.
Using the SAFER Guide to Discover Areas of Risk and Improvements
Using the SAFER Guides to evaluate the risks associated with implementing an EHR system at Allen Hospital was an enlightening experience. It helped me understand the importance of identifying potential risks and addressing them proactively to ensure the success of an informatics project. By identifying risks associated with implementing an EHR system at Allen Hospital, I focused on developing a risk mitigation plan that addresses each identified risk.
This experience taught me the importance of working collaboratively with stakeholders and subject matter experts to develop a comprehensive risk mitigation plan. Identifying risks and developing a mitigation plan requires input from various stakeholders, including IT staff, clinicians, and administrators, to ensure all potential risks are identified and adequately addressed (Bhagat et al., 2020). This experience will be helpful in my future practice as a DNP nurse, where I will be responsible for leading large-scale informatics projects. I now understand the importance of utilizing SAFER Guides to identify potential risks associated with implementing new technology in healthcare settings. I will use this experience to guide my future practice, emphasizing the importance of collaboration and proactive risk management to implement informatics projects in healthcare settings successfully.
In short, the experience of using SAFER Guides to discover areas of risk and focus improvement efforts has provided me with valuable insights and skills that will be useful in my future practice. I now understand the importance of proactive risk management and collaboration to implement informatics projects in healthcare settings successfully.
Conclusions
The SAFER Guides were an invaluable tool in identifying potential risks and areas for improvement related to implementing an Electronic Health Record system at Allen Hospital. Using the SAFER Guides, we better understood the hospital’s current IT infrastructure, contingency planning, system interfaces, patient identification, clinical workflow, and communications (Dash et al., 2019). With this knowledge, we can now develop a comprehensive risk mitigation plan that addresses these areas and ensures the successful implementation of the EHR system. As a DNP nurse, the experience of using the SAFER Guides has been beneficial in preparing for future informatics/technology implementation projects and enhanced my understanding of the importance of risk assessment and mitigation in healthcare technology.
References
Adane, K., Gizachew, M., & Kendie, S. (2019). The role of medical data in efficient patient care delivery: A review. Risk Management and Healthcare Policy, Volume 12(12), 67–73.
https://doi.org/10.2147/rmhp.s179259
Aguirre, R. R., Suarez, O., Fuentes, M., & Sanchez-Gonzalez, M. A. (2019). Electronic health record implementation: A review of resources and tools. Cureus, 11(9).
https://doi.org/10.7759/cureus.5649
Bhagat, S., Kapatkar, V. K., Mane, A., Pinto, C., Parikh, D., Mittal, G., & Jain, R. (2020). An industry perspective on risks and mitigation strategies associated with post conduct phase of clinical trial. Reviews on Recent Clinical Trials, 15(1), 28–33.
https://doi.org/10.2174/1574887114666191016103332
Das, S., Siroky, G. P., Lee, S., Mehta, D., & Suri, R. (2020). Cybersecurity: The need for data and patient safety with cardiac implantable electronic devices. Heart Rhythm, 3(7).
https://doi.org/10.1016/j.hrthm.2020.10.009
Dash, S., Shakyawar, S. K., Sharma, M., & Kaushik, S. (2019). Big data in healthcare: Management, analysis and future prospects. Journal of Big Data, 6(1), 1–25.
https://doi.org/10.1186/s40537-019-0217-0
Enticott, J., Johnson, A., & Teede, H. (2021). Learning health systems using data to drive healthcare improvement and impact: A systematic review. BMC Health Services Research, 21(1).
https://doi.org/10.1186/s12913-021-06215-8
Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). Educating nurses for the future. In www.ncbi.nlm.nih.gov. National Academies Press (US).
https://www.ncbi.nlm.nih.gov/books/NBK573912/
Huffstetler, A. N., Epling, J., & Krist, A. H. (2022). The need for electronic health records to support delivery of behavioral health preventive services. JAMA, 5(3).
https://doi.org/10.1001/jama.2022.13391
Keshta, I., & Odeh, A. (2020). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal, 22(2), 177–183.
https://doi.org/10.1016/j.eij.2020.07.003
Khubone, T., Tlou, B., & Mashamba-Thompson, T. P. (2020). Electronic health information systems to improve disease diagnosis and management at point-of-care in low and middle income countries: A narrative review. Diagnostics, 10(5), 327.
https://doi.org/10.3390/diagnostics10050327
McGowan, J., Wojahn, A., & Nicolini, J. R. (2022, February 10). Risk Management Event Evaluation and Responsibilities. PubMed; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK559326/
Melnychuk, E., Sallade, T. D., & Kraus, C. K. (2022). Hospitals as disaster victims: Lessons not learned? Journal of the American College of Emergency Physicians Open, 3(1), e12632.
https://doi.org/10.1002/emp2.12632
Scantlebury, A., Sheard, L., Fedell, C., & Wright, J. (2021). What are the implications for patient safety and experience of a major healthcare IT breakdown? A qualitative study. DIGITAL HEALTH, 7(3), 205520762110100.
https://doi.org/10.1177/20552076211010033
Szarfman, A., Levine, J. G., Tonning, J. M., Weichold, F., Bloom, J. C., Soreth, J. M., Geanacopoulos, M., Callahan, L., Spotnitz, M., Ryan, Q., Pease-Fye, M., Brownstein, J. S., Ed Hammond, W., Reich, C., & Altman, R. B. (2022). Recommendations for achieving interoperable and shareable medical data in the USA. Communications Medicine, 2(1).
https://doi.org/10.1038/s43856-022-00148-x
Tsai, C. H., Eghdam, A., Davoody, N., Wright, G., Flowerday, S., & Koch, S. (2020). Effects of electronic health record implementation and barriers to adoption and use: A scoping review and qualitative analysis of the content. Life, 10(12), 327.
https://doi.org/10.3390/life10120327
