Title
Clinical handover improvement in context: exploring tensions between user-centred approaches and standardisation.
Abstract
User-centred approaches in the development and evaluation of health information systems promote the importance of involving users and understanding their social contexts to optimise the quality and safety of these systems for patient care. Simultaneously, the standardisation of clinical practices has also been advocated to improve the quality and safety of patient care. In the context of clinical handover improvement within three different departments in one tertiary teaching hospital, this paper highlights the potential for tensions between these two approaches and explores their implications. Based on a user-centred approach, the paper reports on the unique requirements identified within each of the three departments for an information system to support improved clinical handover. Each department had clinical practices, work cultures and user requirements that needed to be considered and accommodated. This led to the project developing distinct minimum data sets for each of the three departments that posed challenges for efforts to standardise handover practices across the hospital and for building an integrated information system. While on the one hand accommodating unique departmental user requirements was valuable, they revealed the potential for the introduction of quality and safety risks at the organisational level. To resolve these tensions, the project team developed an approach called flexible standardisation that has now been embedded in Australia's national guidelines on clinical handover improvement.
Year
DOI
Venue
2013
10.3233/978-1-61499-293-6-48
Studies in Health Technology and Informatics
Keywords
Field
DocType
User-centred approaches,standardisation,health information systems,quality and safety
Information system,Health information technology,Knowledge management,Project team,Needs assessment,Health informatics,Medicine,User requirements document,Clinical handover,Handover
Conference
Volume
ISSN
Citations 
194
0926-9630
0
PageRank 
References 
Authors
0.34
0
3
Name
Order
Citations
PageRank
Ming Chao Wong166.42
Paul Turner2317.53
Kwang Chien Yee3106.20