Be wary of information technology/systems as a quick fix

Abbie Tapp-Pearson, Director, Patient Safety Organization, TeamHealth

 Early in my healthcare career I became frustrated with the never-ending and ever-changing processes that clinicians are asked to do daily aside from patient care. I recall thinking of ways to help streamline processes to ease the burden clinicians carry with regulatory requirements and productivity goals. But I was extremely conflicted with how streamlining processes may impact patient care. Let’s discuss an example that most of us are pretty familiar with - electronic medical records (EMRs).

Theoretically, EMRs were supposed to increase patient safety by reducing human error (i.e. illegible manuscript, misplacement of paper records, inability to obtain records in a timely fashion). In reality, many EMRs are still not interoperable, audio dictations can still lead to incorrectness of the chart and…I think we all understand what it feels like when there are connectivity issues when trying to chart or pull up patient information quickly.All of which can affect patient safety and clinician satisfaction/longevity in different ways. My point is that technological solutions, including systems and applications, should not be considered the fix for broken processes.

EMRs are here to stay, as they should be, but we now have new issues and different broken processes to fix! This concept should be considered when contemplatingany technological/system solution’s implementation in healthcare. Basically, identify the issue and then get to the root cause of the true issue. If the root cause can be fixed or enhanced by technology, great! But always consider what new problems might arise.It’s best to fix the broken processes, like removing bottlenecks, updating policies/procedures and even providing more education, before implementing an easy fix with information systems. Over reliance on IT/system solutions can be worse than doing nothing at all!

Enhancing patient handoffs and communications between clinicians is always on patient safety personnel radars.I worked with IT for almost an entire year to develop a super slick electronic handoff tool. On the flip side,I know a wonderful clinical leader that was just as effective or more so with developing a safer culture through requiring a standard paper hand off tool. My point is that sometimes the best solution is through simple change management strategies that are driven by excellent leaders as opposed to relying on a computer software or application to fix all of our problems.

At the end of the day, clinicians pursued a career in healthcare because they want to care for other human-beings. Everyone who works in healthcare share a common goal-to provide solutions so that patientsare able to receive the safest and best care possible from registration to being discharged. And for the most part, everyone I’ve had the pleasure of working with has a true desire for patient safety and enhancing the delivery of healthcare, especially during such interesting times as these. But be cautious with identifying issues and bringing quick solutions. Instead, next time when you have an issue, try this approach:

1. State the perceived problem;
2. Plan a root cause analysis with key stakeholders;
3. Identify multiple solutions and their downward effects on key individuals and existing processes; and
4. Then weigh your options with the key stakeholders.

You might be surprised what solution you land on. Therefore, be wary of marketing and over-promising that a new system will fix all of our issues in healthcare, andtake the time you need to develop a multifaceted approach including change management strategies. And don’t forget to be flexible after implementing a new solution. New issues are going to occur, so it is important to ensure your team is flexible and agile with to address those issues that arise!