In the majority of hospitals, the tasks of optimization of the EHR are bestowed upon the IT specialist and, in the cases of large hospital networks, a unified IT department. They conduct frequent rundowns of the system, analyze its deficiencies, and perform repairs and optimizations as needed. One of the most occurring mistakes is the lack of clinician involvement in the process. Instead of working with doctors and nurses about how should the EHR be optimized to ensure patient safety, safe use, and ease of implementation, IT specialists usually operate in isolation, along with the overarching guidelines and their own views on how things should work, disconnected from the reality in the field.
The hospital reviewed with the SAFER guidelines has a similar trend. While the IT specialists typically conduct surveys of what should be changed about the existing system, they do not go in-depth and often inconvenience the working staff with inappropriate timings. It is easier for the nurses to write that “everything is fine” during the working day rather than spend 30 minutes filling out the form. In addition, clinicians do not have any influence on how the IT changes the EHR, instead of being forced to accept the changes post-factum. The hospital should create a board where clinician representatives would work with the IT to ensure better and more appropriate results.
Such a conjoined effort would provide the hospital with several benefits. First, the changes to safety of use and patient security would better reflect on the situation in the hospital when the initiative for change comes from the clinicians rather than the IT. Second, the specialists involved would be more motivated to acknowledge and adopt the technological changes coming from their peers. The quality of the improvements would increase as well, in accordance with SAFER guidelines.