Institutional decision-making to select patient care devices

Identifying venues to promote patient safety

Alla Keselman, Vimla Patel, Todd R. Johnson, Jiajie Zhang

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Many medical errors that involve drug infusion devices are related to classic interface problems. Although manufacturers are becoming increasingly aware of human factors design considerations, many devices that are currently on the market are still sub-optimal for human use. This places significant responsibility for device selection on institutional purchasing groups. Theories of naturalistic decision-making point to many potential strengths and pitfalls of group decision-making processes that may affect the final outcome. This paper describes a retrospective analysis of decision-making process for infusion pump selection in a large hospital and focuses on factors related to patient safety. Through a series of detailed interviews and a study of relevant documentation we characterized the nature of the decision-making, patterns of communication, and the roles of different participants. Findings show that although the process involves a number of different professional groups and committees, the information flow among them is restricted. This results in inadequate representation of critical device usability considerations in the decision-making process. While all participants view device safety as an important consideration in the selection process, administrators (who are the final decision-makers) tend to equate safety with technical accuracy and reliability, paying less attention to the role of human factors in safe device use. Findings suggest that collaborative communication technology and automated evidence-based guidelines could provide support to institutional decision-making, ensuring that the process is efficient, effective, and ultimately safe for the patients.

Original languageEnglish (US)
Pages (from-to)31-44
Number of pages14
JournalJournal of Biomedical Informatics
Volume36
Issue number1-2
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

Fingerprint

Patient Safety
Decision Making
Patient Care
Decision making
Equipment and Supplies
Human engineering
Drug infusion
Group Purchasing
Communication
Equipment Safety
Safety devices
Infusion Pumps
Medical Errors
Purchasing
Administrative Personnel
Documentation
Pumps
Guidelines
Interviews
Technology

Keywords

  • Human factors design
  • Institutional decision-making
  • Patient safety

ASJC Scopus subject areas

  • Computer Science Applications
  • Health Informatics

Cite this

Institutional decision-making to select patient care devices : Identifying venues to promote patient safety. / Keselman, Alla; Patel, Vimla; Johnson, Todd R.; Zhang, Jiajie.

In: Journal of Biomedical Informatics, Vol. 36, No. 1-2, 01.01.2003, p. 31-44.

Research output: Contribution to journalArticle

Keselman, Alla ; Patel, Vimla ; Johnson, Todd R. ; Zhang, Jiajie. / Institutional decision-making to select patient care devices : Identifying venues to promote patient safety. In: Journal of Biomedical Informatics. 2003 ; Vol. 36, No. 1-2. pp. 31-44.
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