Daily 'safety huddles' may identify more EHR safety issues

In almost a year of “safety huddles” among staff at one hospital, 7 percent of safety issues discussed involved electronic health records (EHRs), usually regarding the technology not working properly.

The single-hospital study, published in the Journal of the American Medical Informatics Association, analyzed notes from 249 days of 15-minute safety briefings held every weekday at an unnamed “midsized tertiary-care hospital” in its first year of operation. The hospital used an Epic EHR system.

In those 249 days of briefings, which involved around 30 to 40 people from multiple departments within the hospital, 245 safety concerns related to EHRs were discussed. Most concerns dealt with EHR technology not working properly or at all.

Hardware and software malfunctions accounted for nearly 33 percent of the safety issues, with the most common complaint being data had been lost or delayed. Some examples of those errors included inaccurate patient information automatically being loaded into charts or data which had previously been reviewed failing to load into a patient’s record.

Some of the issues did go unnoticed until after they affected patients, including an incorrect prescription for a blood pressure medication which wasn’t identified until after it had been administered.

The number of safety concerns reported was higher than in previous studies, suggesting this hospital’s “safety huddles” are a more comfortable forum for staff members to bring up EHR problems.

“Safety concerns were communicated verbally during the daily huddle briefings and provided a less burdensome and more conversational mechanism by which to discuss sensitive issues,” wrote lead author Dean Sittig, PhD, professor at UT Health’s School of Biomedical Informatics.

Limitations of the study included its single-center nature, the reliability of the huddle notes, and whether those involved in the briefings recognized safety issues as EHR-related. Sittig wrote it’s possible the nature of the huddle could mean fewer serious safety events would be addressed during those meetings.

There was some indication EHR-related concerns declined as staff members got more familiar with the system, but only to a point. In the first three months of the hospital opening, EHR-related safety issues accounted for more than 12 percent of all reported issues. For in the final three months of the study, however, the proportion remain constant at around 7 percent.