Association between limiting the number of open records in a tele-critical care setting and retract–reorder errors |
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| Authors: | Chiedozie Udeh Christina Canfield Isaac Briskin Aaron C Hamilton |
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| Institution: | 1. Department of Intensive Care and Resuscitation, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA;2. Medical Operations, Cleveland Clinic, Cleveland, Ohio, USA;3. Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA;4. Department of Hospital Medicine, Quality and Patient Safety Institute, Cleveland Clinic, Cleveland, Ohio, USA |
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| Abstract: | BackgroundWrong patient selection errors may be tracked by retract–reorder (RAR) events. The aim of this quality improvement study was to assess the impact of reducing the number of concurrently open electronic health records from 4 to 2 on RAR errors generated by a tele-critical care service.MethodsThe study encompassed 32 months before and 21 months after restriction. Chi-Square test of proportions and T statistical process control chart for rare events were used.ResultsThere were 156 318 orders with 57 RAR errors (36.5/100 000 orders) before restriction, and 122 587 orders with 34 errors (27.7/100 000 orders) after. Rates were not statistically different (P = .20), but analysis was underpowered. When plotted on a T control chart, random variation was detected between RAR errors.ConclusionWe found no significant difference in RAR errors in the tele-critical care setting after open record limitation. Other strategies should be studied to reduce wrong patient selection errors. |
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| Keywords: | information technology medical order entry systems telemedicine patient safety medical errors |
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