What are the implications for patient safety and experience of a major healthcare IT breakdown? A qualitative study.

Arabella Scantlebury,Cindy Fedell,L Sheard,J Wright

doi:10.1177/20552076211010033

Abstract

IntroductionTo explore the impact of a three-week downtime to an electronic pathology system on patient safety and experience.MethodsQualitative study consisting of semi-structured interviews and a focus group at a large NHS teaching hospital in England. Participants included NHS staff (n = 16) who represented a variety of staff groups (doctors, nurses, healthcare assistants) and board members. Data were collected 2–5 months after the outage and were analysed thematically.ResultsWe present the implications which the IT breakdown had for both patient safety and patient experience. Whilst there was no actual recorded harm to patients during the crisis, there was strong and divided opinion regarding the potential for a major safety incident to have occurred. Formal guidance existed to assist staff to navigate the outage but there was predominantly a reliance on informal workarounds. Junior clinicians seemed to struggle without access to routine blood test results whilst senior clinicians seemed largely unperturbed. Patient experience was negatively affected due to the extensive wait time for manually processed diagnostic tests, increasing logistical problems for patients.ConclusionThe potential negative consequences on patient safety and experience relating to IT failures cannot be underestimated. To minimise risks during times of crisis, clear communication involving all relevant stakeholders, and guidance and management strategies that are agreed upon and communicated to all staff are recommended. To improve patient experience flexible approaches to patient management are suggested.

Highlights

To explore the impact of a three-week downtime to an electronic pathology system on patient safety and experience
In 2016, a large NHS teaching hospital in England experienced a failure to its electronic pathology system
We set the scene by reporting descriptively key information that gives context to the outage. This is necessary for readers to be able to understand the resultant implications for patient safety and experience

Summary

Introduction

To explore the impact of a three-week downtime to an electronic pathology system on patient safety and experience. In 2016, a large NHS teaching hospital in England experienced a failure to its electronic pathology system. At the time of the outage, pathology services were provided by a neighbouring hospital. The disruption caused was unprecedented, partly, because of the outages duration, and because it affected two large NHS teaching hospitals, which are reliant on pathology for a number of clinical services (e.g. transfusion, microbiology). Provide clinical services, but an entire local health community. Over the last two decades, there has been a global drive towards digitising healthcare.[1] As a result, there are a number of key clinical areas for which electronic systems are integral to day-to-day patient management, diagnosis and decision-making.

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