Introduction to “health informatics, healthcare quality and safety, and healthcare simulation: the new triad to advance healthcare operations”

ABSTRACT

This special themed international issue explores the multiple facets of health informatics, healthcare quality and safety, and healthcare simulation from different parts of the world. The papers in this issue fall into two broad themes. The first theme uses the intersection to address better management of care including physical design layout. The second theme examines innovative uses of the triad to prevent critical and non-critical safety events. The collection of papers culminates with a position paper reporting on the interdependence that is emerging as an important triad for research and practice within medical education, system development and testing, and teamwork and communication and concludes with reducing imprecision and factual errors in handoffs. Findings from the special collection of papers can inform managers and leaders on advancing operations in healthcare settings.

KEYWORDS:

• Health informatics
• healthcare quality and safety
• healthcare simulation
• healthcare operations

Health Informatics, Healthcare Quality and Safety, and Healthcare Simulation are each independent and well-respected domains that contribute to healthcare organisation operations and health outcomes. While each can stand alone, there is a growing body of literature to suggest that any two, informatics and quality and safety, quality and safety and simulation, informatics and simulation, when combined could contribute more than when in isolation. However, practitioners are just now starting to consider the value and power of all three: informatics, quality and safety, and simulation, as a tightly knit triad, as a means to advance health outcomes, improve quality metrics, and decrease errors.

The papers in this issue fall into two broad themes within the broader context of the intersection between health informatics, healthcare quality and safety, and healthcare simulation.

The first theme uses the intersection to address better management of care from care protocols to physical design layout. In terms of care protocols, Shivers, Feldman, et al., present the use of a septic shock computerised protocol to drive decision-making at the paediatric intensive care bedside. The Technology Acceptance Model (Davis, 1989) suggests that technology will be used if there is a perceived ease of use and perceived usefulness with the technology. Clinicians reported that the computerised protocol was easier to use and more useful than the previous paper-based protocol. Given that sepsis accounts for 60–80% of lost lives per year in childhood and the time to respond is narrow, these findings stand to lead to better care management. In terms of physical design layout, Vahdat, Namin, et al., report on a discrete-event simulation model that is used to estimate the frequency of movements between clinic units. The results demonstrate that improvements to the quality of the patient experience can be achieved through incorporating simulation-optimisation methods into the clinic layout design process. This paper walks the reader through the simulation-optimisation framework.

The second theme focuses on the design and development of innovative techniques to improve patient safety. Register, Brown, et al., describe the design and development of implementing space simulations in six different clinical settings. Their use of simulation in this environment exposed patient and provider safety concerns and patient and provider needs that otherwise may not have been exposed or considered. Omitaomu, Ozmen, et al. bring in the issue of institutional trust and system credibility. Their end-to-end framework provides a model for monitoring hazards in health IT systems as well as analytical methods for characterising and analysing failures in HIT systems. Wu, Deoghare, et al. round out this theme reporting on a simulated hand-off and participants’ navigation patterns in an EHR system mock-up. The results show that the participants frequently used the dashboard as an information hub and as an information resource to help them navigate the EHR system and answer the questions in a nursing call. Moreover, using the dashboard as an information hub can help reduce imprecision and factual errors in handoffs.

The last paper in this issue, a position paper that rounds out the special issue, conducted by Modi, Zengul, et al., helps to create a shared understanding of the intersection. The authors take the position that healthcare simulation is used as a vehicle to improve healthcare quality and safety; health informatics facilitates healthcare quality and safety; and healthcare simulation tests and trains users of health information systems. The authors further posit that the use of simulation for testing and teaching software applications and hardware that are implemented in the clinical care environment, hold promise to avoid risking lives during testing periods.

The papers in this special issue address various operational issues and provide multiple perspectives on how health informatics, healthcare quality and safety, and simulation can impact, streamline, and increase patient safety and overall satisfaction.

Disclosure statement

No potential conflict of interest was reported by the authors.