Whose work practice? Situating an electronic triage system within a complex system.
An electronic triaging system was introduced into a busy children's hospital emergency department. Within 18 months of its introduction, amidst complaints from staff about patient safety related to work slow downs, a decision was made to stop using the system. In this paper we examine issues that arose with the introduction of the electronic triaging system, and discuss these in relation to decision making in complex systems. We suggest that difficulties with the triage system resulted partly because data resulting from the triage encounter are used in several domains including the care domain, the access domain, the federal equity and accountability domain, the local accounting and quality domain and the research domain, each of which has different primary stakeholders, with varying needs. Greater attention to identification of data requirements for each of these domains and acknowledgement of varied stakeholder interests prior to software selection and implementation may improve future implementations.
Balka
Ellen
E
School of Communication, Simon Fraser University, Vancouver Coastal Health, Canada.
Whitehouse
Sandy
S
D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006776:Hospitals, Pediatric / Q000458:organization & administration*; D006801:Humans; D012449:Safety; D013997:Time Factors; D014218:Triage / Q000379:methods*