Abstract
BackgroundOur aim was to explore NHS staff perceptions and experiences of the impact on patient safety of introducing a maternity system.MethodsQualitative semi-structured interviews were conducted with 19 members of NHS staff who represented a variety of staff groups (doctors, midwives, health care assistants), staff grades (consultant and midwife grades) and wards within a maternity unit. Participants represented a single maternity unit at a NHS teaching hospital in the North of England. Interviews were conducted during the first 12 months of the system being implemented and were analysed thematically.ResultsParticipants perceived there to be an elevated risk to patient safety during the system’s implementation. The perceived risks were attributed to a range of social and technical factors. For example, poor system design and human error which resulted in an increased potential for missing information and inputting error.ConclusionsThe first 12 months of introducing the maternity system was perceived to and in some cases had already caused actual risk to patient safety. Trusts throughout the NHS are facing increasing pressure to become paperless and should be aware of the potential adverse impacts on patient safety that can occur when introducing electronic systems. Given the potential for increased risk identified, recommendations for further research and for NHS trusts introducing electronic systems are proposed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0299-y) contains supplementary material, which is available to authorized users.
Highlights
Our aim was to explore National Health Service (NHS) staff perceptions and experiences of the impact on patient safety of introducing a maternity system
A concerted effort to maintain balance was made during interviews; it became clear that challenges to patient safety outweighed perceived benefits and so these concerns were allowed to emerge unconstrained by the interviewer
There is a risk that incorrect information could have been written into paper records, interviewees felt that the system brought new risks, from staff using the system differently and the system allowing the same information to be inputted into different places; increasing the risk of missing information
Summary
Our aim was to explore NHS staff perceptions and experiences of the impact on patient safety of introducing a maternity system. Policy and financial support for NHS trusts to implement electronic records implies a strong evidence base supporting the idea that these systems can improve health outcomes and quality of care. The literature is limited, as demonstrated in a recent systematic review [6] of eHealth technologies and their impact on the quality and safety of healthcare, which concluded that there is a gap between the proposed and empirically evidenced benefits of eHealth technologies. There is little consideration given in existing literature to potential negative effects of these systems on patient safety, with existing evidence under-cited and predominately from the U.S whose health service has different economic, organisational and structural foundations from the UK [7,8,9,10,11]. In their review [6], Black et al provided some discussion into this and suggested that the lack of evidence may be due to publication bias, with potential conflicts of interest making it difficult to publish negative findings [6]
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