A PRA-based evaluation of alternative white boards in an ED setting

There is a generally promoted view in healthcare that information technology (IT) will be a panacea for the various crises in that industry, from improving patient safety to reducing costs and expanding availability of care. This study was based in a busy emergency department (ED) in a large urban area in the USA and describes a PRA-based assessment of the relative risks to patient safety from using existing physical white boards as patient status tracking devices vs. IT-based devices intended to perform the same function. While both types appear to be work satisfactorily under nominal (routine) conditions, those times when the ED becomes a high-tempo stressed environment tends to lead to greater problems with the IT-based system. This is because it is less malleable than the physical system and therefore less readily adaptable to the complexities of work that arise in the high-tempo periods. Additionally, under these conditions, it had failure modes that were not anticipated before its implementation. These are seen as potentially important lessons for healthcare in its move to IT-based "solutions" in other areas.