Evidence map›Paper›PMID 29688461›Full record

ArticleJournal of the American Medical Informatics Association : JAMIA2018

Transition to a new electronic health record and pediatric medication safety: lessons learned in pediatrics within a large academic health system.

Kimberly Whalen, Emily Lynch, Iman Moawad, Tanya John, Denise Lozowski, Brian M Cummings

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Informatics Association : JAMIA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Which Electronic Health Record System Should We Use? A Systematic Review.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2022
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  10. Advancing the Science of Electronic Health Record Transitions.Journal of general internal medicine · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kimberly WhalenMassachusetts General Hospital, Boston, MA, USA.
Emily LynchMassachusetts General Hospital, Boston, MA, USA.
Iman MoawadMassachusetts General Hospital, Boston, MA, USA.
Tanya JohnMassachusetts General Hospital, Boston, MA, USA.
Denise LozowskiMassachusetts General Hospital, Boston, MA, USA.
Brian M CummingsMassachusetts General Hospital, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: While the electronic health record (EHR) has become a standard of care, pediatric patients pose a unique set of risks in adult-oriented systems. We describe medication safety and implementation challenges and solutions in the pediatric population of a large academic center transitioning its EHR to Epic. Methods: Examination of the roll-out of a new EHR in a mixed neonatal, pediatric and adult tertiary care center with staggered implementation. We followed the voluntarily reported medication error rate for the neonatal and pediatric subsets and specifically monitored the first 3 months after the roll-out of the new EHR. Data was reviewed and compiled by theme. Results: After implementation, there was a 5-fold increase in the overall number of medication safety reports; by the third month the rate of reported medication errors had returned to baseline. The majority of reports were near misses. Three major safety themes arose: (1) enterprise logic in rounding of doses and dosing volumes; (2) ordering clinician seeing a concentration and product when ordering medications; and (3) the need for standardized dosing units through age contexts created issues with continuous infusions and pump library safeguards. Conclusions: Future research and work need to be focused on standards and guidelines on implementing an EHR that encompasses all age contexts.

Indexed as

Electronic Health RecordsMedical Order Entry SystemsOrganizational InnovationPediatricsAcademic Medical CentersHumansMedication ErrorsNear Miss, HealthcarePatient Safety

Identifiers

PMID29688461
PMCPMC7647031

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.