Evaluation of the implementation of an electronic occurrence reporting system at Eastern Health, Newfoundland and Labrador (Phase One)

Elliott, Pamela G. (Pamela Gale) (2010) Evaluation of the implementation of an electronic occurrence reporting system at Eastern Health, Newfoundland and Labrador (Phase One). Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

In June 2008, Eastern Health completed the implementation of an electronic occurrence reporting system (Phase One). Phase One included a pre-go-live site (an integrated services site in a rural setting) and three go-live sites (acute care, long term care and community health in an urban setting). The evaluation study had a dual purpose: (a) to assess and report on the impact of the implementation of the electronic occurrence reporting system on achieving its stated objectives, particularly those that could be measured within the timelines of the project and (b) to analyze findings to identify contributions to the literature in the recently developing field of implementations of electronic occurrence reporting systems in health care. -- The evaluation was guided by the framework outlined in the report, "Towards an Evaluation Framework for Electronic Health Records Initiatives" (Neville et al., 2004), which emphasizes stakeholder involvement in evaluation studies, pre/post comparative study design, and triangulation of data where possible. Data were collected from several sources such as project documentation, administrative occurrence reporting records, surveys, focus groups and key informant interviews. -- The findings of this study provide evidence that frontline staff and managers support the implementation of the electronic occurrence reporting system, that there is little difference in results between the various sectors of the continuum of health services and the new system had both positive and negative impacts on the role of frontline managers. There were limitations related to some of the findings due to the small sample size, particularly the long term care sector. -- Many benefits were realized such as: (a) an increase in the number of occurrences reported, (b) increase in the number of occurrences reported within 48 hours, (c) increase in the number of occurrences reported by staff other than registered nurses, (d) increase in the number of close calls reported, (e) positive changes in the patient safety culture, (f) improved timelines for notification of high alert occurrences to managers, and (g) satisfaction with the electronic tool related to ease of use, accessibility, and consistency. -- The implementation process also encountered challenges, such as issues related to customizing the software and development of the classification system for coding occurrences. These issues impacted on the ability of the managers to obtain timely customized reports and to close out files. These challenges are currently being addressed by the Project Implementation Team. Participants noted that resolving these issues will enhance the many positive impacts of the system already realized. Lessons learned during the Phase One implementation process (including the identification of facilitators and barriers) resulted in recommendations that can assist with future implementations.

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