Abstract
BackgroundThe use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. The use of health IT to apply safety science principles (e.g., standardization) to L&D unit processes may further advance perinatal safety.MethodsSemi-structured interviews were conducted with L&D units participating in the Agency for Healthcare Research and Quality’s (AHRQ’s) Safety Program for Perinatal Care (SPPC) to assess units’ experience with program implementation. Analysis of interview transcripts was used to characterize the process and experience of using health IT for applying safety science principles to L&D unit processes.ResultsForty-six L&D units from 10 states completed participation in SPPC program implementation; thirty-two (70%) reported the use of health IT as an enabling strategy for their local implementation. Health IT was used to improve standardization of processes, use of independent checks, and to facilitate learning from defects. L&D units standardized care processes through use of electronic health record (EHR)-based order sets and use of smart pumps and other technology to improve medication safety. Units also standardized EHR documentation, particularly related to electronic fetal monitoring (EFM) and shoulder dystocia. Cognitive aids and tools were integrated into EHR and care workflows to create independent checks such as checklists, risk assessments, and communication handoff tools. Units also used data from EHRs to monitor processes of care to learn from defects. Units experienced several challenges incorporating health IT, including obtaining organization approval, working with their busy IT departments, and retrieving standardized data from health IT systems.ConclusionsUse of health IT played an integral part in the planning and implementation of SPPC for participating L&D units. Use of health IT is an encouraging approach for incorporating safety science principles into care to improve perinatal safety and should be incorporated into materials to facilitate the implementation of perinatal safety initiatives.
Highlights
The use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units
Health IT applications can be used as a means for applying safety science principles to quality and safety initiatives as in the Agency for Healthcare Research and Quality’s (AHRQ) Comprehensive Unit-based Safety Program (CUSP), which we recently adapted for use in L&D Units as the AHRQ Safety Program for Perinatal Care (SPPC) [7]
This paper describes how L&D units that implemented the AHRQ Safety Program for Perinatal Care (SPPC), a comprehensive perinatal safety program based on CUSP, incorporated the use of health IT to enable safety science principles for improving the culture of patient safety, teamwork and communication, and the quality of care processes [7]
Summary
The use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. Health IT applications are increasingly used within Labor and Delivery (L&D) units to promote safety including clinical decision support systems, computerized medication order entry, and medication safety devices [2]. These health IT applications aid providers in treatment decisions, support more complete and timely documentation, promote medication safety, and enable standardized data collection for quality improvement [2,3,4,5,6]. CUSP aims to improve the unit culture of safety by combining teamwork and communication, leadership, and safety science principles [8] These principles include standardizing processes, creating independent checks, and learning from defects. The safety science principle of learning from defects requires data about what happened surrounding an untoward event which can be captured and retrieved from checklists and other standardized documentation tools for evaluation of defects and quality improvement activities [4, 5]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call