The Identification and Management of Patient Information Problems by Collaborative Patient-care Teams
Open Access
- Author:
- Murphy, Alison Ryan
- Graduate Program:
- Information Sciences and Technology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- October 30, 2015
- Committee Members:
- Madhu Reddy, Dissertation Advisor/Co-Advisor
Madhu Reddy, Committee Chair/Co-Chair
Erika S Poole, Committee Chair/Co-Chair
Mary Beth Rosson, Committee Member
Roxanne Louise Parrott, Committee Member - Keywords:
- information technology
health
healthcare
hospitals
collaboration
electronic health records - Abstract:
- Hospitals are highly collaborative, information-intensive environments where patient-care teams rely on the availability of accurate and complete information to provide safe and effective patient care. However, patient-care team members frequently encounter patient information problems (PIPs). These PIPs include any issues related to patient information that impact the patient-care team’s ability to perform their work (e.g., wrong, missing, outdated information). Although these PIPs have always existed in paper records, there is an increasing need to focus on PIPs in electronic records due to the tremendous growth in the use of health information technology (HIT). Researchers in the Medical Informatics and Human-Computer Interaction communities are currently studying what causes these PIPs in hospitals, and the impacts that PIPs can have on the patient-care workflow. Additionally, Computer-Supported Cooperative Work researchers are exploring how the collaborative nature of hospital work affects the information management activities of patient-care teams. Yet, there is still limited research on how patient-care team members actually identify and then manage the PIPs that they encounter during their work. After all, if these PIPs are not identified and properly fixed, they can result in medical decisions being made on wrong or outdated information, or even result in the occurrence of medical errors that could harm patients. In this dissertation study, I address this limitation in existing research by conducting an ethnographic field study in a hospital’s emergency department and in-patient ward. I used qualitative methods including observations, shadowing, semi-structured interviews, and artifact analysis to examine how patient-care teams identify and manage PIPs that they encounter. The contributions of my study include: (a) providing a conceptual understanding of the ways that patient-care teams identify and manage PIPs, including the development of a PIP taxonomy and conceptual framework, and (b) developing socio-technical recommendations for how to improve the design of hospital policies and HIT design that will better support the identification and management of PIPs by collaborative patient-care teams. The research motivation of this dissertation study highlights the importance of better understanding PIPs that occur in hospitals in order to prevent or mitigate any negative impacts that they can have on patient care. The contributions of this research extend the conceptual understanding of PIPs and provide tools and design recommendations that can better support collaborative patient-care teams in their identification and management of PIPs.