Risk Assessment of Technology-induced Errors in Health Care

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (951 download)

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Book Synopsis Risk Assessment of Technology-induced Errors in Health Care by : Tien-Sung (David) Chio

Download or read book Risk Assessment of Technology-induced Errors in Health Care written by Tien-Sung (David) Chio and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This study demonstrates that hybrid methods can be used for measuring the risk severity of technology-induced errors (TIE) that result from use of health information technology (HIT).The objectives of this research study include: 1. Developing an integrated conceptual risk assessment model to measure the risk severity of technology-induced errors. 2. Analyzing the criticality and risk thresholds associated with TIE's contributing factors. 3. Developing a computer-based simulation model that could be used to undertake various simulations of TIE's problems and validate the results.Using data from published papers describing three sample problems related to usability and technology-induced errors, hybrid methods were developed for assessing the risk severity and thresholds under various simulated conditions.A risk assessment model (RAM) and its corresponding steps were developed. A computer-based simulation of risk assessment using the model was also developed, and several runs of the simulation were carried out. The model was tested and found to be valid. Based on assumptions and published statistics obtained by publically available databases, we measured the risk severity and analyzed its criticality to classify risks of contributing factors into four different classes. The simulation results validated the efficiency and efficacy of the proposed methods with the sample problems.

Improving Diagnosis in Health Care

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Publisher : National Academies Press
ISBN 13 : 0309377722
Total Pages : 473 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis Improving Diagnosis in Health Care by : National Academies of Sciences, Engineering, and Medicine

Download or read book Improving Diagnosis in Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2015-12-29 with total page 473 pages. Available in PDF, EPUB and Kindle. Book excerpt: Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Qualitative Study of Technology-Induced Errors in Healthcare Organizations

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Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (88 download)

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Book Synopsis Qualitative Study of Technology-Induced Errors in Healthcare Organizations by : Paule Bellwood

Download or read book Qualitative Study of Technology-Induced Errors in Healthcare Organizations written by Paule Bellwood and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Health information technology is continuously changing and becoming more complex and susceptible to errors. It is both an essential and disruptive innovation that requires proper management of risks arising from its use. To properly manage these risks, there is a need to, first, determine how healthcare organizations in Canada are addressing the issue of errors arising from the use of health information technology (i.e., technology-induced errors). The purpose of this thesis is to determine the level of technology-induced error awareness in Canadian healthcare organizations, to identify processes and procedures at these organizations aimed at addressing, managing, and preventing technology-induced errors, as well as to identify factors that contribute to technology-induced errors. The study finds that, based on the currently available literature, information about these errors in healthcare is not complete. This prevents the development and application of effective health information technology risk management solutions. The research from the semi-structured interviews finds that the definition of technology-induced errors is not consistent among the study participants. The research from the semi-structured interviews also finds a lack of consensus on factors that cause technology-induced errors as well as a lack of reporting mechanisms available that are specifically aimed at reporting technology-induced errors in healthcare. This confirms that there is a lack of technology-induced error awareness among Canadian healthcare organizations, which prevents the ability to properly address, manage, and prevent these errors.

Medical Error and Harm

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Publisher : Productivity Press
ISBN 13 : 9781439836941
Total Pages : 0 pages
Book Rating : 4.8/5 (369 download)

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Book Synopsis Medical Error and Harm by : Milos Jenicek

Download or read book Medical Error and Harm written by Milos Jenicek and published by Productivity Press. This book was released on 2010-07-02 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent debate over healthcare and its spiraling costs has brought medical error into the spotlight as an indicator of everything that is ineffective, inhumane, and wasteful about modern medicine. But while the tendency is to blame it all on human error, it is a much more complex problem that involves overburdened systems, constantly changing technology, increasing specialization, and a cycle of continual funding shortfalls made even more acute by resource-wasting inefficiencies. Medical Error and Harm: Understanding, Prevention and Control, presents the work of long time physician and teacher Milos Jenicek, a pioneering expert on epidemiology, evidence-based medicine, and critical thinking and decision making in the health sciences. Providing an extraordinarily comprehensive overview of the subject that is as thorough and scientifically organized as it is accessible and free of rhetoric, Dr. Jenicek — Presents a short history of error in general across various domains of human activity and endeavor, including concepts, methodologies of study, and management applications Provides semantic and taxonomic classifications of challenges in medical error and harm, two distinct domains Explores approaches used to investigate and ameliorate challenges in medicine and other health sciences Explains why, when, and how studies and decisions regarding errors should be carried out, such as whether risk assessment should be undertaken in the diagnosis, treatment, or prognosis stage Covers essential strategies for mitigating errors in the broader framework of medical care, specifically in community medicine and public health Considers the ever-growing role of physicians in tort law and litigation The book also discusses whether dealing with errors is a learned skill and looks at how much of the problem with medical error is caused by the medical community’s failure to teach, learn, and understand everything there is to know about medical error, including the often neglected importance of critical thinking skills. Understanding and correcting this shortfall is a primary responsibility of every health professional, one they can begin to realize with the study of these pages.

Patient Safety and Quality

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Publisher : Department of Health and Human Services
ISBN 13 :
Total Pages : 592 pages
Book Rating : 4.:/5 (318 download)

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Book Synopsis Patient Safety and Quality by : Ronda Hughes

Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Advances in Patient Safety

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Publisher :
ISBN 13 :
Total Pages : 526 pages
Book Rating : 4.7/5 (54 download)

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Book Synopsis Advances in Patient Safety by : Kerm Henriksen

Download or read book Advances in Patient Safety written by Kerm Henriksen and published by . This book was released on 2005 with total page 526 pages. Available in PDF, EPUB and Kindle. Book excerpt: v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

Reliability Technology, Human Error, and Quality in Health Care

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Publisher : CRC Press
ISBN 13 : 1420065599
Total Pages : 212 pages
Book Rating : 4.4/5 (2 download)

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Book Synopsis Reliability Technology, Human Error, and Quality in Health Care by : B.S. Dhillon

Download or read book Reliability Technology, Human Error, and Quality in Health Care written by B.S. Dhillon and published by CRC Press. This book was released on 2008-02-21 with total page 212 pages. Available in PDF, EPUB and Kindle. Book excerpt: The effective and interrelated functioning of system reliability technology, human factors, and quality play an important role in the appropriate, efficient, and cost-effective delivery of health care. Simply put, it can save you time, money, and more importantly, lives. Over the years a large number of journal and conference proceedings articles o

Error Reduction in Health Care

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Publisher : John Wiley & Sons
ISBN 13 : 1118001567
Total Pages : 336 pages
Book Rating : 4.1/5 (18 download)

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Book Synopsis Error Reduction in Health Care by : Patrice L. Spath

Download or read book Error Reduction in Health Care written by Patrice L. Spath and published by John Wiley & Sons. This book was released on 2011-02-25 with total page 336 pages. Available in PDF, EPUB and Kindle. Book excerpt: Error Reduction in Health Care Completely revised and updated, this second edition of Error Reduction in Health Care offers a step-by-step guide for implementing the recommendations of the Institute of Medicine to reduce the frequency of errors in health care services and to mitigate the impact of errors when they do occur. With contributions from noted leaders in health safety, Error Reduction in Health Care provides information on analyzing accidents and shows how systematic methods can be used to understand hazards before accidents occur. In the chapters, authors explore how to prioritize risks to accurately focus efforts in a systems redesign, including performance measures and human factors. This expanded edition covers contemporary material on innovative patient safety topics such as applying Lean principles to reduce mistakes, opportunity analysis, deductive adverse event investigation, improving safety through collaboration with patients and families, using technology for patient safety improvements, medication safety, and high reliability organizations. The Editor

An Analysis of Health Information Technology-related Adverse Events

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Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (119 download)

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Book Synopsis An Analysis of Health Information Technology-related Adverse Events by : Victoria Pequegnat

Download or read book An Analysis of Health Information Technology-related Adverse Events written by Victoria Pequegnat and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Health information technology has been widely accepted as having the potential to decrease the prevalence of adverse events and improve workflows and communication between healthcare workers. However, the emergence of health technologies has introduced a new type of medical error. Technology-induced errors are a type of medical error that can result from the use of health information technology in all stages of the health information systems life cycle. The purpose of this study is to identify what types of technology-induced errors are present in the key health information technology vendors in the United States, determine if there are any similarities and differences in technology-induced errors present among the key health information technology vendors in the United States, and determine what methods are utilized, if any, by the key vendors of health information technologies to address and/or resolve reported technology-induced errors. This study found that the most commonly reported technology-induced errors are those related to unexpected system behaviours, either through their direct use or through the communication between systems. It was also found that there is a large difference in the number of adverse events being reported by the key health information technology vendors. Just three vendors represent 85% of the adverse events included in this study. Finally, this study found that there are vendors who are posting responses to reported technology-induced errors and these vendors are most commonly following up with software updates and notifications of safety incidents. This study highlights the importance of analyzing adverse event reports in order to understand the types of technology-induced errors that are present in health information technology.

To Err Is Human

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Publisher : National Academies Press
ISBN 13 : 0309068371
Total Pages : 312 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis To Err Is Human by : Institute of Medicine

Download or read book To Err Is Human written by Institute of Medicine and published by National Academies Press. This book was released on 2000-03-01 with total page 312 pages. Available in PDF, EPUB and Kindle. Book excerpt: Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

Digital Health

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Publisher : Oxford University Press
ISBN 13 : 0197503136
Total Pages : 273 pages
Book Rating : 4.1/5 (975 download)

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Book Synopsis Digital Health by : Eric D. Perakslis

Download or read book Digital Health written by Eric D. Perakslis and published by Oxford University Press. This book was released on 2021 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drawing on expert interviews, original research, and personal storytelling, Digital Health explores the theory, science, and applications behind the uses of emerging digital technologies in healthcare.

Safety of Health IT

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Publisher : Springer
ISBN 13 : 3319311239
Total Pages : 255 pages
Book Rating : 4.3/5 (193 download)

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Book Synopsis Safety of Health IT by : Abha Agrawal

Download or read book Safety of Health IT written by Abha Agrawal and published by Springer. This book was released on 2016-08-01 with total page 255 pages. Available in PDF, EPUB and Kindle. Book excerpt: This practical text provides an overview of the adverse consequences of health information technology (HIT) and its impact on patient safety. Specific cases of errors and risks related to various types of HIT are featured along with best practices for patient safety, workflows and organizational standards. The full impact of these challenges with meaningful solutions are openly examined. Written from a clinical perspective, healthcare professionals within multiple settings will find this timely book an invaluable resource to this essential and bourgeoning technology.

Resident Duty Hours

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Publisher : National Academies Press
ISBN 13 : 0309131529
Total Pages : 427 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Resident Duty Hours by : Institute of Medicine

Download or read book Resident Duty Hours written by Institute of Medicine and published by National Academies Press. This book was released on 2009-04-27 with total page 427 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.

Preventing Medication Errors

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Publisher : National Academies Press
ISBN 13 : 0309101476
Total Pages : 481 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Preventing Medication Errors by : Institute of Medicine

Download or read book Preventing Medication Errors written by Institute of Medicine and published by National Academies Press. This book was released on 2007-01-11 with total page 481 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 1996 the Institute of Medicine launched the Quality Chasm Series, a series of reports focused on assessing and improving the nation's quality of health care. Preventing Medication Errors is the newest volume in the series. Responding to the key messages in earlier volumes of the seriesâ€"To Err Is Human (2000), Crossing the Quality Chasm (2001), and Patient Safety (2004)â€"this book sets forth an agenda for improving the safety of medication use. It begins by providing an overview of the system for drug development, regulation, distribution, and use. Preventing Medication Errors also examines the peer-reviewed literature on the incidence and the cost of medication errors and the effectiveness of error prevention strategies. Presenting data that will foster the reduction of medication errors, the book provides action agendas detailing the measures needed to improve the safety of medication use in both the short- and long-term. Patients, primary health care providers, health care organizations, purchasers of group health care, legislators, and those affiliated with providing medications and medication- related products and services will benefit from this guide to reducing medication errors.

To Err Is Human

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Publisher : National Academies Press
ISBN 13 : 0309261740
Total Pages : 312 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis To Err Is Human by : Institute of Medicine

Download or read book To Err Is Human written by Institute of Medicine and published by National Academies Press. This book was released on 2000-04-01 with total page 312 pages. Available in PDF, EPUB and Kindle. Book excerpt: Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

Errors and Adverse Consequences as a Result of Information Technology Use in Healthcare

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Publisher :
ISBN 13 :
Total Pages : 128 pages
Book Rating : 4.:/5 (864 download)

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Book Synopsis Errors and Adverse Consequences as a Result of Information Technology Use in Healthcare by : Christopher Kiess

Download or read book Errors and Adverse Consequences as a Result of Information Technology Use in Healthcare written by Christopher Kiess and published by . This book was released on 2012 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Information Technology (HIT) has become an integral component of healthcare today. The HITECH Act (2009) and Meaningful Use objectives stand to bring wide-sweeping adoption and implementations of HIT in small, medium and large sized healthcare organizations across the country. Though recent literature has provided evidence for the benefits of HIT in the profession, there have also been a growing number of reports exploring the adverse effects of HIT. There has not, however, yet been a systematic account of the adverse effects of HIT in the healthcare system. The current push for HIT coupled with a lack of critical appraisal of the potential risks of implementation and deployment within the medical literature has led to a general unquestioning and unregulated acceptance of the implementation of technology in medicine and healthcare as a positive addition with little or no risk. While the benefits of HIT are clear, a review of the existing studies in the literature would provide a holistic vision of the adverse effects of HIT as well as the types and impact within the nation's health care system to inform future HIT development and implementation. The development of a general understanding of these adverse effects can serve as a review and summary for the use of informatics professionals and clinicians implementing HIT as well as providing future direction for the industry in HIT implementations. Additionally, this study has value for moving forward in informatics to develop frameworks for implementation and guidelines and standards for development and regulation of HIT at a federal level. This study involves the use of an integrative literature review to identify and classify the adverse effects of HIT as reported in the literature. The purpose of this study is to perform an integrative review of the literature to 1) identify and classify the adverse effects of HIT; 2) determine the impact and prevalence of these effects; 3) identify the recommended actions and best practices to address the negative effects of HIT. This study analyzed 18 articles for HIT-induced error and adverse consequences. In the process, 228 errors and/or adverse consequences were identified, classified and represented in an operational taxonomic schema. The taxonomic representation consisted of 8 master categories and 30 subcategories. Additionally, the prevalence and impact of these errors were evaluated as well as recommendations and best practices in future systems design. This study builds on previous work in the medical literature pertaining to HIT-induced errors and adverse consequences and offers a unique perspective in analyzing existing studies in the literature using the integrative review model of research. It is the first work in combining studies across healthcare technologies and analyzing the adverse consequences across 18 studies to form a cohesive classification of these events in healthcare technology.

Health IT and Patient Safety

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Author :
Publisher : National Academies Press
ISBN 13 : 0309221153
Total Pages : 234 pages
Book Rating : 4.3/5 (92 download)

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Book Synopsis Health IT and Patient Safety by : Institute of Medicine

Download or read book Health IT and Patient Safety written by Institute of Medicine and published by National Academies Press. This book was released on 2012-03-15 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt: IOM's 1999 landmark study To Err is Human estimated that between 44,000 and 98,000 lives are lost every year due to medical errors. This call to action has led to a number of efforts to reduce errors and provide safe and effective health care. Information technology (IT) has been identified as a way to enhance the safety and effectiveness of care. In an effort to catalyze its implementation, the U.S. government has invested billions of dollars toward the development and meaningful use of effective health IT. Designed and properly applied, health IT can be a positive transformative force for delivering safe health care, particularly with computerized prescribing and medication safety. However, if it is designed and applied inappropriately, health IT can add an additional layer of complexity to the already complex delivery of health care. Poorly designed IT can introduce risks that may lead to unsafe conditions, serious injury, or even death. Poor human-computer interactions could result in wrong dosing decisions and wrong diagnoses. Safe implementation of health IT is a complex, dynamic process that requires a shared responsibility between vendors and health care organizations. Health IT and Patient Safety makes recommendations for developing a framework for patient safety and health IT. This book focuses on finding ways to mitigate the risks of health IT-assisted care and identifies areas of concern so that the nation is in a better position to realize the potential benefits of health IT. Health IT and Patient Safety is both comprehensive and specific in terms of recommended options and opportunities for public and private interventions that may improve the safety of care that incorporates the use of health IT. This book will be of interest to the health IT industry, the federal government, healthcare providers and other users of health IT, and patient advocacy groups.