title: Safety huddles to proactively identify and address electronic health record safety.
abstract: OBJECTIVE
  Methods to identify and study safety risks of electronic health records (EHRs) are underdeveloped and largely depend on limited end-user reports. "Safety huddles" have been found useful in creating a sense of collective situational awareness that increases an organization's capacity to respond to safety concerns. We explored the use of safety huddles for identifying and learning about EHR-related safety concerns.
  
  
  METHODS
  Data were obtained from daily safety huddle briefing notes recorded at a single midsized tertiary-care hospital in the United States over 1 year. Huddles were attended by key administrative, clinical, and information technology staff. We conducted a content analysis of huddle notes to identify what EHR-related safety concerns were discussed. We expanded a previously developed EHR-related error taxonomy to categorize types of EHR-related safety concerns recorded in the notes.
  
  
  RESULTS
  On review of daily huddle notes spanning 249 days, we identified 245 EHR-related safety concerns. For our analysis, we defined EHR technology to include a specific EHR functionality, an entire clinical software application, or the hardware system. Most concerns (41.6%) involved " EHR technology working incorrectly, " followed by 25.7% involving " EHR technology not working at all. " Concerns related to "EHR technology missing or absent" accounted for 16.7%, whereas 15.9% were linked to " user errors ."
  
  
  CONCLUSIONS
  Safety huddles promoted discussion of several technology-related issues at the organization level and can serve as a promising technique to identify and address EHR-related safety concerns. Based on our findings, we recommend that health care organizations consider huddles as a strategy to promote understanding and improvement of EHR safety.
authors.affiliation: Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Shailaja
authors.initials: S
authors.lastname: Menon
authors.affiliation: Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Hardeep
authors.initials: H
authors.lastname: Singh
authors.affiliation: Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Traber D
authors.initials: TD
authors.lastname: Giardina
authors.affiliation: Baylor Scott and White, College Station, TX, USA.
authors.forename: William L
authors.initials: WL
authors.lastname: Rayburn
authors.affiliation: Baylor Scott and White, College Station, TX, USA.|Premier Management, Inc., College Station, TX, USA.
authors.forename: Brenda P
authors.initials: BP
authors.lastname: Davis
authors.affiliation: Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Elise M
authors.initials: EM
authors.lastname: Russo
authors.affiliation: University of Texas Health Science Center at Houston, School of Biomedical Informatics and UT-Memorial Hermann Center for Health Care Quality and Safety, Houston, TX, USA.
authors.forename: Dean F
authors.initials: DF
authors.lastname: Sittig
mesh_terms: D057286:Electronic Health Records; D006801:Humans; D061214:Patient Safety; D012189:Retrospective Studies; D017751:Safety Management; D012984:Software; D062606:Tertiary Care Centers / Q000458:organization & administration*; D014481:United States; D057188:Workflow
keywords: electronic health records; health information technology; patient safety; risk management; safety huddles; safety reporting