The impact of electronic records on patient safety: a qualitative study.
Our aim was to explore NHS staff perceptions and experiences of the impact on patient safety of introducing a maternity system.



Qualitative semi-structured interviews were conducted with 19 members of NHS staff who represented a variety of staff groups (doctors, midwives, health care assistants), staff grades (consultant and midwife grades) and wards within a maternity unit. Participants represented a single maternity unit at a NHS teaching hospital in the North of England. Interviews were conducted during the first 12 months of the system being implemented and were analysed thematically.



Participants perceived there to be an elevated risk to patient safety during the system's implementation. The perceived risks were attributed to a range of social and technical factors. For example, poor system design and human error which resulted in an increased potential for missing information and inputting error.



The first 12 months of introducing the maternity system was perceived to and in some cases had already caused actual risk to patient safety. Trusts throughout the NHS are facing increasing pressure to become paperless and should be aware of the  potential adverse impacts on patient safety that can occur when introducing electronic systems. Given the potential for increased risk identified, recommendations for further research and for NHS trusts introducing electronic systems are proposed.
York Trials Unit, Department of Health Sciences, University of York, York, YO10 5DD, UK. Arabella.clarke@york.ac.uk.
Arabella
A
Clarke
Department of Health Sciences, University of York, York, YO10 5DD, UK.
Joy
J
Adamson
Department of Health Sciences, University of York, York, YO10 5DD, UK.
Ian
I
Watt
Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, BD9 6RJ, Bradford, UK.
Laura
L
Sheard
Department of Computer Science, University of York, Yo10 5GH, York, UK.
Paul
P
Cairns
Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, BD9 6RJ, Bradford, UK.
John
J
Wright
D000328:Adult; D001291:Attitude of Health Personnel; D057286:Electronic Health Records / Q000592:standards*; D004739:England; D006771:Hospitals, Maternity / Q000592:standards*; D006801:Humans; D009313:National Health Programs; D061214:Patient Safety / Q000592:standards*; D036301:Qualitative Research
Electronic records; Maternity; NHS; Patient safety; Qualitative