Classification of Health Information Technology-Related Contributing Factors to Patient Safety Events

Objective: Develop a classification for health IT contributing factors that can be used to identify, understand, and eventually reduce the risk of health IT-related patient safety events (or sentinel events). The end result is a more robust classification that enables the accurate description of the adverse event as well as the contributing and causal factors related to health IT to (1) inform and influence organizational actions taken to reduce risk, and (2) help prioritize resources. Methods: A sample of 120 health IT-related sentinel events reported to The Joint Commission were used to perform a confirmatory analysis on a composite health IT classification of contributing factors based on a framework of eight sociotechnical dimensions. Results: An analysis of sentinel events resulted in the identification of over 300 contributing factors that are classified into 50 different types of contributing factors from a possible 77 contributing factors in the classification. The classification of health IT-related contributing factors indicates that health IT-related sentinel events are primarily associated with the sociotechnical dimensions of human interface and workflow and communication. Discussion: Health IT-related contributing factors were identified in eight sociotechnical dimensions with no identified contributing factors falling outside the dimensions. This suggests that the sociotechnical model is sufficient for capturing relevant health IT-related contributing factors. Conclusion: Thoughtful design, careful implementation, safe use, and monitoring health IT in the context of a sociotechnical system can help prevent and mitigate problems before they cause patient harm. The classification provides the necessary foundation for learning how to ensure that the technology we use to treat patients is safe and is used safely.