Impact of heath information technology on the quality of patient care

Amanda Hessels, Linda Flynn, Jeannie P. Cimiotti, Suzanne Bakken, Robyn Gershon

Research output: Contribution to journalArticle

Abstract

Objective To examine the relationships among Electronic Health Record (EHR) adoption and adverse outcomes and satisfaction in hospitalized patients. Materials and Methods This secondary analysis of cross-sectional data was compiled from four sources: (1) State Inpatient Database from the Healthcare Cost Utilization Project; (2) Healthcare Information and Management Systems Society (HIMSS) Dorenfest Institute; (3) Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) and (4) New Jersey nurse survey data. The final analytic sample consisted of data on 854,258 adult patients discharged from 70 New Jersey hospitals in 2006 and 7,679 nurses working in those same hospitals. The analytic approach used ordinary least squares and multiple regression models to estimate the effects of EHR adoption stage on the delivery of nursing care and patient outcomes, controlling for characteristics of patients, nurses, and hospitals. Results Advanced EHR adoption was independently associated with fewer patients with prolonged length of stay and seven-day readmissions. Advanced EHR adoption was not associated with patient satisfaction even when controlling for the strong relationships between better nursing practice environments, particularly staffing and resource adequacy, and missed nursing care and more patients reporting "Top-Box," satisfaction ratings. Conclusions This innovative study demonstrated that advanced stages of EHR adoption show some promise in improving important patient outcomes of prolonged length of stay and hospital readmissions. Strongly evident by the relationships among better nursing work environments, better quality nursing care, and patient satisfaction is the importance of supporting the fundamentals of quality nursing care as technology is integrated into practice.

Original languageEnglish (US)
Number of pages1
JournalOnline Journal of Nursing Informatics
Volume19
Issue number3
StatePublished - Jan 1 2016

Fingerprint

Quality of Health Care
Patient Care
Electronic Health Records
Technology
Nursing Care
Nurses
Patient Satisfaction
Length of Stay
Nursing
Management Information Systems
Delivery of Health Care
Patient Readmission
Least-Squares Analysis
Health Personnel
Health Care Costs
Inpatients
Cross-Sectional Studies
Databases

Keywords

  • Adverse patient events
  • Electronic health records
  • Health information technology
  • Nursing practice environment
  • Patient safety
  • Patient satisfaction

ASJC Scopus subject areas

  • Health Informatics
  • Nursing (miscellaneous)

Cite this

Impact of heath information technology on the quality of patient care. / Hessels, Amanda; Flynn, Linda; Cimiotti, Jeannie P.; Bakken, Suzanne; Gershon, Robyn.

In: Online Journal of Nursing Informatics, Vol. 19, No. 3, 01.01.2016.

Research output: Contribution to journalArticle

Hessels, Amanda ; Flynn, Linda ; Cimiotti, Jeannie P. ; Bakken, Suzanne ; Gershon, Robyn. / Impact of heath information technology on the quality of patient care. In: Online Journal of Nursing Informatics. 2016 ; Vol. 19, No. 3.
@article{bc786d7ffaf14fc3a8c7181785d404a0,
title = "Impact of heath information technology on the quality of patient care",
abstract = "Objective To examine the relationships among Electronic Health Record (EHR) adoption and adverse outcomes and satisfaction in hospitalized patients. Materials and Methods This secondary analysis of cross-sectional data was compiled from four sources: (1) State Inpatient Database from the Healthcare Cost Utilization Project; (2) Healthcare Information and Management Systems Society (HIMSS) Dorenfest Institute; (3) Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) and (4) New Jersey nurse survey data. The final analytic sample consisted of data on 854,258 adult patients discharged from 70 New Jersey hospitals in 2006 and 7,679 nurses working in those same hospitals. The analytic approach used ordinary least squares and multiple regression models to estimate the effects of EHR adoption stage on the delivery of nursing care and patient outcomes, controlling for characteristics of patients, nurses, and hospitals. Results Advanced EHR adoption was independently associated with fewer patients with prolonged length of stay and seven-day readmissions. Advanced EHR adoption was not associated with patient satisfaction even when controlling for the strong relationships between better nursing practice environments, particularly staffing and resource adequacy, and missed nursing care and more patients reporting {"}Top-Box,{"} satisfaction ratings. Conclusions This innovative study demonstrated that advanced stages of EHR adoption show some promise in improving important patient outcomes of prolonged length of stay and hospital readmissions. Strongly evident by the relationships among better nursing work environments, better quality nursing care, and patient satisfaction is the importance of supporting the fundamentals of quality nursing care as technology is integrated into practice.",
keywords = "Adverse patient events, Electronic health records, Health information technology, Nursing practice environment, Patient safety, Patient satisfaction",
author = "Amanda Hessels and Linda Flynn and Cimiotti, {Jeannie P.} and Suzanne Bakken and Robyn Gershon",
year = "2016",
month = "1",
day = "1",
language = "English (US)",
volume = "19",
journal = "Online Journal of Nursing Informatics",
issn = "1089-9758",
publisher = "On-Line Journal of Nursing Informatics",
number = "3",

}

TY - JOUR

T1 - Impact of heath information technology on the quality of patient care

AU - Hessels, Amanda

AU - Flynn, Linda

AU - Cimiotti, Jeannie P.

AU - Bakken, Suzanne

AU - Gershon, Robyn

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Objective To examine the relationships among Electronic Health Record (EHR) adoption and adverse outcomes and satisfaction in hospitalized patients. Materials and Methods This secondary analysis of cross-sectional data was compiled from four sources: (1) State Inpatient Database from the Healthcare Cost Utilization Project; (2) Healthcare Information and Management Systems Society (HIMSS) Dorenfest Institute; (3) Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) and (4) New Jersey nurse survey data. The final analytic sample consisted of data on 854,258 adult patients discharged from 70 New Jersey hospitals in 2006 and 7,679 nurses working in those same hospitals. The analytic approach used ordinary least squares and multiple regression models to estimate the effects of EHR adoption stage on the delivery of nursing care and patient outcomes, controlling for characteristics of patients, nurses, and hospitals. Results Advanced EHR adoption was independently associated with fewer patients with prolonged length of stay and seven-day readmissions. Advanced EHR adoption was not associated with patient satisfaction even when controlling for the strong relationships between better nursing practice environments, particularly staffing and resource adequacy, and missed nursing care and more patients reporting "Top-Box," satisfaction ratings. Conclusions This innovative study demonstrated that advanced stages of EHR adoption show some promise in improving important patient outcomes of prolonged length of stay and hospital readmissions. Strongly evident by the relationships among better nursing work environments, better quality nursing care, and patient satisfaction is the importance of supporting the fundamentals of quality nursing care as technology is integrated into practice.

AB - Objective To examine the relationships among Electronic Health Record (EHR) adoption and adverse outcomes and satisfaction in hospitalized patients. Materials and Methods This secondary analysis of cross-sectional data was compiled from four sources: (1) State Inpatient Database from the Healthcare Cost Utilization Project; (2) Healthcare Information and Management Systems Society (HIMSS) Dorenfest Institute; (3) Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) and (4) New Jersey nurse survey data. The final analytic sample consisted of data on 854,258 adult patients discharged from 70 New Jersey hospitals in 2006 and 7,679 nurses working in those same hospitals. The analytic approach used ordinary least squares and multiple regression models to estimate the effects of EHR adoption stage on the delivery of nursing care and patient outcomes, controlling for characteristics of patients, nurses, and hospitals. Results Advanced EHR adoption was independently associated with fewer patients with prolonged length of stay and seven-day readmissions. Advanced EHR adoption was not associated with patient satisfaction even when controlling for the strong relationships between better nursing practice environments, particularly staffing and resource adequacy, and missed nursing care and more patients reporting "Top-Box," satisfaction ratings. Conclusions This innovative study demonstrated that advanced stages of EHR adoption show some promise in improving important patient outcomes of prolonged length of stay and hospital readmissions. Strongly evident by the relationships among better nursing work environments, better quality nursing care, and patient satisfaction is the importance of supporting the fundamentals of quality nursing care as technology is integrated into practice.

KW - Adverse patient events

KW - Electronic health records

KW - Health information technology

KW - Nursing practice environment

KW - Patient safety

KW - Patient satisfaction

UR - http://www.scopus.com/inward/record.url?scp=84994236428&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994236428&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:84994236428

VL - 19

JO - Online Journal of Nursing Informatics

JF - Online Journal of Nursing Informatics

SN - 1089-9758

IS - 3

ER -