Focus on Pediatric Patient Safety on Universal Children’s Day 2018

Focus on Pediatric Patient Safety on Universal Children’s Day 2018 Universal Children’s Day that highlighted the importance of pediatric patient safety was celebrated on November 20th this year.

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Universal Children’s Day is celebrated on November 20th each year. Established by the United Nations in 1954, this day aims at promoting international togetherness and improving children's welfare. To celebrate the day this year, UN had recommended going blue, wearing blue clothing or accessories and sharing with the world on social media. Being an experienced medical transcription company, we also used this opportunity to create awareness about the increasing complexities in pediatric patient care and medication errors, thus making pediatric patient safety an issue of high priority.

Pediatric patient safety efforts focus on preventing injury to children caused directly by the health care system itself. According to the American Academy of Pediatrics, clinicians must be involved to ensure the success of patient safety as part of larger quality-improvement efforts.

EHR Usability Issues and Pediatric Medication Errors According to a recent study published in Health Affairs, pediatric populations are uniquely vulnerable to the usability and safety challenges of electronic health records (EHRs), particularly those related to medication, yet little is known about the specific issues contributing to hazards. To understand specific usability issues and medication errors in the care of children, the research team from Georgetown University School of Medicine in Washington, D.C.analyzed 9,000 patient safety reports, for the period 2012–17, from three different health care institutions that were likely related to EHR use.

The team placed each EHR usability-related patient safety event into one of four categories. The four categories included system feedback, visual display, data entry, and workflow support.

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Of these 9,000 reports, • 3,243 (36 percent) had a usability issue that contributed to the medication event • 609 (18.8 percent) of the 3,243 might have resulted in patient harm • 33 percent did not cause harm and did not require monitoring • 18 percent required monitoring or an intervention to prevent harm • 3 percent resulted in temporary harm The general pattern of usability challenges and medication errors were the same across the three sites. While the most common usability challenges were associated with system feedback and the visual display, the most common medication error was improper dosing.

According to the lead author of this study, “While EHRs have improved care and safety under certain circumstances; these findings suggest that thousands of patients may be put at risk because of usability challenges that stem from the design, implementation, customization, or use of this technology.”

According to another report, published earlier in March 2018 in JAMAby the same author, EHR usability may have been a contributing factor to some possible patient harm events. In this study, of the 1.735 million reported safety events, 1956 explicitly mentioned an EHR vendor to blame and another 557 had language suggesting that EHR usability contributed to possible patient harm. The study identified patient harm scenarios involving seven categories of usability, including data entry, alerting and interoperability. The usability challenges were associated with four types of clinical processes, including order entry placement and medication administration. But as patient safety reports contain only limited information, it was difficult to identify causal factors. Additional research was needed to determine causal relationships between EHR usability and patient harm and the frequency of occurrence. www.medicaltranscriptionservicecompany.com

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Some of the top EHR usability issues include not clearly indicating the required fields, consistent buttons in software, data entry issues, incorrect alerts and system automations. Optimizing pediatric EHR systems with a focus on usability improvements may help to reduce the potential for EHR-associated patient harm. Availability of EHR integrated pediatric transcription services from an experienced firm will help pediatricians to a great extent in reducing EHR usability issues.

MedStar Health and The Pew Charitable Trusts have offered certain recommendations to the federal government for making health IT systems safer for children. Those recommendations for a certification program include - Require EHR vendors to provide evidence that they are employing a user-centered design process; Require that usability test participants represent the clinical end users; Define and require the use of rigorous test cases to assess usability and safety; Recognize that EHR implementation is crucial to safety; and consider the entire EHR life-cycle—not just the development phase—when granting certification; and Encourage transparency in sharing usability and safety challenges to improve safety and EHR product.

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