Format

Send to

Choose Destination
J Oncol Pract. 2019 Jun;15(6):e529-e536. doi: 10.1200/JOP.18.00507. Epub 2019 Apr 22.

Clinician Perspectives on Electronic Health Records, Communication, and Patient Safety Across Diverse Medical Oncology Practices.

Author information

1
1 University of Michigan School of Public Health, Ann Arbor, MI.
2
2 University of Michigan Rogel Cancer Center, Ann Arbor, MI.
3
3 University of Michigan School of Nursing, Ann Arbor, MI.
4
4 Michigan Oncology Quality Consortium, Ann Arbor, MI.
5
5 University of Michigan, Ann Arbor, MI.

Abstract

PURPOSE:

We know little about how increased technological sophistication of clinical practices affects safety of chemotherapy delivery in the outpatient setting. This study investigated to what degree electronic health records (EHRs), satisfaction with technology, and quality of clinician-to-clinician communication enable a safety culture.

METHODS:

We measured actions consistent with a safety culture, satisfaction with practice technology, and quality of clinician communication using validated instruments among 297 oncology nurses and prescribers in a statewide collaborative. We constructed an index to reflect practice reliance on EHRs (1 = "all paper" to 5 = "all electronic"). Linear regression models (with robust SEs to account for clustering) examined relationships between independent variables of interest and safety. Models were adjusted for clinician age.

RESULTS:

The survey response rate was 68% (76% for nurses and 59% for prescribers). The mean (standard deviation) safety score was 5.3 (1.1), with a practice-level range of 4.9 to 5.4. Prescribers reported fewer safety actions than nurses. Higher satisfaction with technology and higher-quality clinician communication were significantly associated with increased safety actions, whereas increased reliance on EHRs was significantly associated with lower safety actions.

CONCLUSION:

Practices vary in their performance of patient safety actions. Supporting clinicians to integrate technology and strengthen communication are promising intervention targets. The inverse relationship between reliance on EHRs and safety suggests that technology may not facilitate clinicians' ability to attend to patient safety. Efforts to improve cancer care quality should focus on more seamless integration of EHRs into routine care delivery and emphasize increasing the capacity of all care clinicians to communicate effectively and coordinate efforts when administering high-risk treatments in ambulatory settings.

PMID:
31009284
DOI:
10.1200/JOP.18.00507

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center