Health Information Compliance Alert

Published on Sun Jul 26, 2009 PDF

Important: Plan to train employees on technology on an ongoing basis.

Using technology to develop a more efficient workflow is every practice's goal. But without careful planning and staff orientation, you're risking a costly failure that may even decrease your ability to care for patients. Do your part by helping to carry out these best practices:

The challenge: While many people expect technology to act as a cure-all -- by simplifying medication dispensement, supporting doctors' prescription decision, and facilitating the sharing of health information, for instance -- health providers face a unique challenge that other industries don't, remarked Mark Chassin, MD, president of The Joint Commission during the recent teleconference "Safely Implementing Health Information and Converging Technologies." "We can't take people out of the provision of health care and replace them completely with automated processes," Chassin said, "We have to be mindful of the safety risks and preventable errors that technology can create or perpetuate.

The solution: Top priorities are creating and utilizing technology-related policies and procedures, putting qualified individuals in charge of technology strategy oversight, and facilitating education on technology and how it contributes to patient safety. "This sounds basic but it is fundamental to creating the foundation for safety as it relates to technology," emphasized Peter Angood, MD, JC vice president and chief patient safety officer, during the teleconference.

It's essential to persist beyond just one round of training and education, said Angood, "there needs to be ongoing education in these processes."

• Examine workflow processes and procedures for risks and inefficiencies. Encourage employees from all disciplines -- including clinical and clerical -- to identify and communicate issues they encounter during a conversion so that vendors can resolve any issues prior to a technology implementation.

• Actively involve clinicians and staff who will use or be affected by the technology. Promote multidisciplinary team work throughout all stages of a technology solution, including the planning, selection, design, reassessment, and ongoing quality improvement.

• Continuously monitor for problems to help vendors address any issues as quickly as possible. Ask employees to take note of workarounds or systems errors that they encounter when a new technology is introduced. If the vendor has not already done so, suggest that it establish an emergent issues desk/phone line staffed by project experts and champions to respond to employees' questions.

• Establish a training program for all types of clinicians and operations staff who will be using the technology and provide frequent refresher courses. Ensure that you have appropriately designed training content for the target staff. Focus training on how the technology will benefit patients and staff by eliminating inefficiencies, minimizing delays, and reducing redundancies. Hold training sessions close to the time of the new system's implementation.

• Develop and communicate policies that outline which staff members are responsible for technology implementation, use, oversight, and safety review. Keep in mind that such policies may require you to adjust job descriptions, particularly if the technology is brand new to your practice.

• Help avoid potentially harmful CPOE drug orders by training staff to comply with review/sign-off requirements rather than permitting staff to occasionally bypass such steps out of convenience. Ensure that nursing managers enforce the proper use of medication administration records (MARs).

• Eliminate environmental distractions to reduce human error and improve patient safety. It's easy to overlook nuances of the physical work environment, but HR can help advocate for working conditions that help employees use technology more effectively. It's of primary importance to eliminate undue distractions, such as noise or patient interruptions, for employees who perform data entry.

• Promote a culture of ongoing error and near-miss reporting. While vendors will have created automated systems to keep track of system failures, a computer program can't capture the nuance that a human can. Encourage supervisors to collect regular reports on what's not working with the new system, particularly in the critical post-implementation period.

• Re-evaluate security and confidentiality protocols and training efforts. As technology becomes a greater part of record-keeping, your organization will have to reassess HIPAA compliance. Take the reins on revamping training materials and written hospital policies on privacy compliance.

Resource: To access a JC Sentinel Event Alert on this topic, visit www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_42.htm. Checklist adapted specifically for HR professionals from the original JC text.