Nurses Know: EHRs Improve Patient Safety

April 10, 2013
A new AHRQ-funded study found what shouldn’t surprise any of us: that nurses in hospitals with fully implemented EHRs are reporting fewer medication errors and cultures of improved patient safety.

Earlier this month, the federal Agency for Healthcare Research and Quality (AHRQ) publicized the results of a study that AHRQ had funded. This new study adds yet one more element of documentation to something we already knew: electronic health records (EHRs) improve nursing care quality, patient safety, and effectiveness.

As the article on the AHRQ website noted, “University of Pennsylvania researchers surveyed 16, 362 nurses working in 316 hospitals in four states (California, Florida, New Jersey, and Pennsylvania). Nurses were asked about their workload and patient outcomes, as well as their hospital’s patient safety culture using items from the AHRQ Hospital Survey on Patient Safety Culture. Of the 316 hospitals, only seven percent had a basic EHR system functioning on all patient care units,” AHRQ noted.

The result? Nurses from hospitals with fully implemented EHRs  were “significantly less likely to report unfavorable outcomes” than were those in hospitals without fully implemented EHRs. Indeed, AHRQ noted, “Fewer nurses in the fully implemented hospitals reported frequent medication errors, poor quality of care, and poor confidence in a patient being ready for discharge.” They were also 14 percent less likely to report that “things fell between the cracks” when patients were transferred between units.

As we all know, nurses are the glue in patient care delivery in hospitals, the clinicians who are there from moment to moment at the patient bedside, supporting the physicians’ diagnoses and orders and carrying out numberless critical caregiving and patient safety tasks for patients. Indeed, on a moment-to-moment basis, they are usually more aware of the patient safety culture of their hospitals than doctors are.

So when nurses judge the quality of care delivery and the level of their organizations’ patient safety culture, it’s important for everyone to listen. And, no surprise: nurses working in hospitals with completed EHR implementations judge their organizations to be safer and to have fewer patient safety problems.

We all know that new studies are emerging virtually every week in clinical and professional journals, as researchers examine all the various aspects of EHR implementation and adoption. But not all studies are equal. Personally, I think it’s important to ask those individuals in hospitals who are closest to the rubber-meets-the-road realities of patient care delivery to tell us what matters. And when nurses in EHR-facilitated hospitals report reduced medication and other errors and better transitions of care, we know EHRs are having a real impact. So let’s keep asking all the clinicians what their experiences have been with EHRs—and then let’s listen to what they have to say, and use their testimony to further improve our clinical information systems. It’s a beneficial—and very productive—circle.