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Safety Huddles Prove Useful to Ensuring EHR Patient Safety

New research of Epic EHR use highlights the benefits of safety huddles to improving patient safety.

By Kate Monica

- The authors of a recent study funded by the Agency for Healthcare Research and Quality found regular 15-minute meetings by administrative, clinical, and IT staff can enable hospitals to identify and address EHR-related patient safety concerns. Menon et al. reviewed data gathered during safety huddles at a midsized hospital, which began the practice following its Epic EHR go-live in August 2013.

Study suggests safety huddles are useful for ensuring safety of patient information.

According to the authors, the meetings initially arose as a means to prevent EHR security gaps. Providers were instructed to use the meetings to share information, review recent health information technology-related patient safety issues, and help teams draw up plans for coordinated patient care. 

“Despite calls for greater attention to EHR-related safety risks, most HCOs and providers have limited awareness of these problems. To achieve the transformational benefits promised by pioneering EHR designers and developers, HCOs must ensure that health information technology–related patient safety is an organizational priority,” wrote Menon et al.

The EHR patient safety risks range from faulty system EHR design and usability to improper EHR use by clinicians. According to recent literature, a concerted effort to keep health information safety at the forefront of providers’ collective consciousness establishes EHR safety as an industry-wide priority

Over the course of a year, the team of researchers obtained notes from daily safety huddles that addressed 245 EHR-related safety concerns over 249 days.

An average safety huddle opened with providers sharing any safety concerns and discussing all “great catches” made over the past 24 hours. “Great catches” denote proper safety behaviors and practices that prevent issues with patient safety. The meeting closed out with providers taking the group’s pulse on overall patient satisfaction.

“To ensure that the huddle process led to closing the loop, all unresolved issues were forwarded to the quality improvement department for follow-up, and actions taken were reported back at a future safety huddle,” the authors observed.

According to the findings, 41.6 percent of safety concerns involved “EHR technology working incorrectly, followed by 25.7 percent involving EHR technology not working at all.” Another16.7 percent of safety concerns were attributed to “EHR technology missing or absent” while 15.9 percent concerned “user errors.”

The safety huddles were successful in encouraging open discussions of health information technology-related problems among healthcare providers and appeared effective in indicating and ameliorating these concerns.

“These short, routing debriefings are designed to engage frontline clinical and administrative staff in discussions about existing or emerging safety and performance issues. Safety huddles and safety briefings have been associated with increases in reporting of safety concerns and improvements in patient outcomes,” the authors claimed.

In fact, after one of the largest US healthcare systems implemented safety huddles as a daily ritual, reports of safety events increased by 40 percent.

While the study bodes well for recurring EHR-related patient safety meetings, the team of researchers acknowledged several limitations.

“Daily huddles only lasted [approximately] 20 minutes, and notes on the brief discussions that ensued were manually compiled by a single note-taker. We could not confirm the validity of safety concerns documented, and the reports often lacked sufficient details about why these issues emerged. Thus, underlying causes of these events could not always be determined.”

These issues withstanding, the study’s results revealed a correlation between safety huddles and increased awareness of EHR-related safety risks.

The authors ultimately recommended that healthcare organizations implement safety huddles to emphasize health information technology-related patient safety as an industry priority and improve EHR safety.

“In conclusion, our study suggests that the ’blame-free’ culture created by safety huddles supports open communication among key administrative, clinical, and information technology staff,” they maintained. “Safety huddles could potentially serve as an important methodology for institutions to identify, understand, and address the complexity of EHR-related patient safety concerns.”

Safety huddles are one of many safety measures the healthcare industry is taking to ensure EHR patient safety. In late 2016, eClinicalWorks issued a statement recommending users install all software updates and ensure the accuracy of treatment orders to avoid certain potential risks.

This study is another step forward in an industry-wide effort toward streamlining EHR use by addressing challenges that inhibit optimal EHR use to improve overall patient safety.

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