Evidence map›Paper›PMID 40269997›Full record

ArticleAdvances in simulation (London, England)2025

Human factors and systems simulation methods to optimize peri-operative EHR design and implementation.

Mirette Dubé, Jonathan D Hron, Susan Biesbroek, Myrna Chan-MacRae, AEliot Shearer, Rocco Landi, Melanie Swenson, Daniel J Kats, Doreen White, Reilly Birmingham and 2 more

Abstract read
In one paragraph

Article in Advances in simulation (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Review
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

12 authors.

Mirette DubéHealthcare Systems Simulation International Inc, 51 GlenEagles Terrace, Cochrane, AB, T4C 1W4, Canada. Mirette@HealthcareSSI.com.
Jonathan D HronBoston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Susan BiesbroekHealthcare Systems Simulation International Inc, 51 GlenEagles Terrace, Cochrane, AB, T4C 1W4, Canada.
Myrna Chan-MacRaeHuman Factors and Systems Design, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
AEliot ShearerDepartment of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Rocco LandiHarvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
Melanie SwensonBoston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Daniel J KatsBoston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Doreen WhiteBoston Children's Hospital, 9 Hope Ave, Waltham, MA, 02453, USA.
Reilly BirminghamBoston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Lauren CoogleChildren's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Jennifer ArnoldImmersive Design Systems, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The increase in adoption of Electronic Health records (EHR) in healthcare can be overwhelming to users and pose hidden safety threats and inefficiencies if the system is not well aligned with workflows. This quality improvement study, facilitated from September 2023-April 2024, aimed to proactively test a new EHR using systems focused simulation and Human factors methods, prior to go-live, in a peri-operative children's hospital setting to improve safety, efficiency and usability of the EHR. The project was conducted at a large, academic, quaternary care children's hospital undergoing a transition from one EHR to another. Two cycles of usability testing followed by in situ simulations focused on testing the new EHR with interprofessional peri-operative team members prior to go live. Usability testing, using relevant clinical workflows, was completed over zoom using the EHR "testing" environment with individual care providers across multiple peri-operative roles. In situ simulations were facilitated in the actual peri-operative and Otolaryngology clinic spaces with full interprofessional teams. Qualitative data was collected and summarized through debriefing and recordings of the sessions. Human factors and patient safety principles were integrated throughout the recommendations. A total of 475 recommendations were made to improve the safety, efficiency, usability, and optimization of the EHR. The outcomes included a range of usability and system issues including latent safety threats and their impact on safe and quality patient care. There was a plethora of usability improvements, including some critical issues that were uncovered and mitigated prior to the go live date.

Indexed as

Electronic health recordHealthcareHuman factorsInformation technologyPatient safetyQuality improvementSimulationSystems simulationUsability testing

Identifiers

PMID40269997
PMCPMC12020211

What OpenQuestion holds

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Registered trials

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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.