Practice makes perfect
Health professionals in any practice setting can use the Safety Assurance Factors for EHR Resilience (SAFER) guides to assess the organization’s electronic health record (EHR)-related patient safety risks based on a list of recommended practices. Health care professionals do not need to review the guides and implement the best practices in any specific order, says Hardeep Singh, MD. Each of the nine SAFER guides analyzes a specific EHR system component:
1. The High Priority Practices guide provides an overview of the eight other guides and allows clinicians to check whether their organization is adhering to basic patient safety practices in its EHR system, such as permitting clinicians to override computer-generated clinical interven- tions and ensuring they are using the EHR to order medications and tests. It enables prac- tices to decide which of the guides they need to complete immediately to ensure patient safety.
2. The Organizational Responsibilities guide ad- dresses possible errors in the EHR system that could put patients at risk. It includes recom- mended practices, such as regular EHR train- ing and support to help ensure safe EHR use.
3. The Contingency Planning guide helps practic- es prepare for times when computer systems are down. Recommendations include provid- ing staff training on recovery procedures and making hard copies of important documents.
4. The System Configuration guide encourages users to test the EHR system to ensure proper hardware and software setup. For example, practices can house the EHR in a physically secure site.
5. The System Interfaces guide helps the practice confirm all EHR-related software systems work together. It recommends ensuring all clinical vocabulary is the same in each system and establishing a system of information exchange that is clear so users know when the system cannot transmit or receive messages or crucial information.
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6. The Patient Identification guide ensures the system can identify the correct patient so prescriptions and test results don’t get mixed up. Recommendations include making sure the EHR system warns users when they attempt to create a new record for a patient with the same first and last name as another patient.
7. The Computerized Provider Order Entry (CPOE) with Decision Support guide helps practices safeguard electronic orders. Recom- mended practices include training and testing clinicians on CPOE operations before giving them credentials to log in to the EHR system.
8. The Test Results Reporting and Follow-up guide helps practices safely manage and share diagnostic test results. It includes recommend- ed practices such as flagging abnormal test results and putting mechanisms in place to forward results from one clinician to another.
9. The Clinician Communication guide focuses on the safe use of EHRs among clinicians. Recom- mended practices include keeping copies of clinician-to-clinician communications in the EHR system and putting mechanisms in place to monitor the timeliness of acknowledgment and response to messages.
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