Management of a critical downtime event involving integrated electronic health record
Journal Publication ResearchOnline@JCUAbstract
Background: There are few descriptions of management of unplanned hospital-wide digital downtime and impact on patient care in health literature. Aim: The aim of this study was to undertake a qualitative review of a prolonged critical technology downtime event in an Australian hospital in 2017. Methods: Inductive content analysis was conducted on data collected through face-to-face, semi-structured, individual interviews conducted with nine hospitals employees (five nurses with direct-care/operational responsibilities, and four executive staff, including nursing) who played a role in the incident. Findings: Analysis of the data using an open-source R package led to the extraction of 139 codes, 13 first-level categories, and 4 main categories. Main categories extracted were: impact of event, response to the event, resilience and institutional reserve, and challenges and learnings. Discussion: The overall experience for interview participants was positive. Effective communication methods, particularly vertical communication, enabled multi-disciplinary teams (comprising nursing, medical and pharmacy personnel) to safely transition back from downtime paper records to the integrated electronic health record with no harm to patients. Participants identified teamwork contributed to a sense of comradery with clinical colleagues and executive staff. Contingency planning and training are essential for ensuring safe and effective management of technology downtime events. Conclusion: The prolonged digital disruption and subsequent recovery was managed effectively using a face-to-face communication and support approach. This approach reduced the impact of the digital downtime and ensured patient safety. The data analysis strategy was enhanced using an computer-assisted qualitative data analysis software.
Journal
Collegian
Publication Name
Collegian
Volume
27
ISBN/ISSN
1322-7696
Edition
N/A
Issue
N/A
Pages Count
11
Location
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Publisher
Elsevier
Publisher Url
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Publisher Location
N/A
Publish Date
N/A
Url
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Date
N/A
EISSN
N/A
DOI
10.1016/j.colegn.2020.02.002