Development and evaluation of an electronic hospital referral system: a human factors approach. Issue 6 (2nd June 2020)

• Record Type: Journal Article
• Authors: Woodward, Matthew; De Pennington, Nicholas; Grandidge, Carly; McCulloch, Peter; Morgan, Lauren
• Is Part Of: Ergonomics. Volume 63:Issue 6(2020)
• Page Start: 710
• Page End: 723
• Publication Date: 2020-06-02
• Subjects: Hospital referral -- human factors -- ergonomics -- quality improvement -- health information technology; Human engineering -- Periodicals; Cybernetics -- Periodicals; Industrial management -- Periodicals; Ergonomie -- Périodiques; Cybernétique -- Périodiques; Gestion d'entreprise -- Périodiques; 620.8205
• DOI: 10.1080/00140139.2020.1748232
• Languages: English
• ISSNs: 0014-0139

Abstract

Abstract: Coordinating care across hospitals has been identified as a patient safety risk as referrals are often paper-based and poorly documented. Electronic referral systems have the potential to improve the situation but can fail to gain uptake. We applied a human factors/ergonomics (HFE) approach to place analysis of local workflow and user engagement central to the development of a new regional electronic referral system. The intervention was evaluated with a before-and-after study. Referral quality improved, referrals containing sufficient clinical information for continuation of care increased from 36.9% to 83.5% and completeness of referral information significantly improved. There was a 35.7% reduction in the number of calls to the on-call specialist, and the mean period between admission and surgery for expedited transfers was reduced. Applying HFE informed design with use-based evidence; the system maintains sustained uptake three years after implementation. Reliable recording of information translates to better patient safety during inter-hospital transitions. Practitioners summary: This study developed, implemented and evaluated a clinical referral system using a human factors approach. Process analysis and usability studies were used to inform the application requirements and design. Region-wide implementation in hospitals resulted in the improved quality and completeness of clinical referral information and efficiencies in the referral process.