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UBC Theses and Dissertations

Characterization and management of technology-mediated adverse events in primary and community care Recsky, Chantelle

Abstract

BACKGROUND: Healthcare organizations are investing in health information technology (HIT) and putting greater emphasis on care in primary and community care settings. While intended to support the delivery of care, HIT can also bring about unanticipated consequences including technology-mediated adverse events (TMAE) (i.e., unintended harm, or potential harm, that involved a HIT-based system). For example, information required for coordinating and delivering client care may be stored in two or more electronic record systems, which creates the potential for missing information, breakdowns in the continuity of care, and may even cause harm to clients. METHODS & RESULTS: A multi-study research project was conducted at a large organization in Western Canada, consisting of: 1) A scoping review of the literature on TMAE and harm in primary and community care settings, which revealed that the current body of evidence is under-developed; 2) A retrospective descriptive study of TMAE reported in primary and community care settings, which found TMAE are diverse and warrant consideration from a sociotechnical perspective; 3) An integrated knowledge translation (IKT) approach for co-creating and applying new knowledge to address TMAE, from which a process for safety huddles and rapid sociotechnical analysis of TMAE was co-produced; and 4) A qualitative descriptive study about how clinical informatics specialists perceived their experiences in managing TMAE, which determined that research using an IKT approach is beneficial to study TMAE, and safety huddles and rapid sociotechnical analysis of TMAE may help to improve care. CONCLUSION: Research in the area of HIT safety in primary and community care settings is under-developed, yet healthcare services are continuing to place greater emphasis on both technology and non-acute services. This research suggests that harm related to HIT can occur in these settings, demonstrated the sociotechnical nature of harm in this context, and found safety huddles and rapid sociotechnical analysis of TMAE to be a feasible method to address TMAE. Further research, incorporating multiple disciplinary perspectives and action-oriented strategies, is needed to gain insight into the impact of TMAE in primary and community care settings and take action to ensure HIT safety going forward.

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Attribution-NonCommercial-NoDerivatives 4.0 International