Electronic Health Record Adoption and Nurse Reports of Usability and Quality of Care: The Role of Work Environment

Applied Clinical Informatics
Ann Kutney-LeeLinda H Aiken

Abstract

Despite evidence suggesting higher quality and safer care in hospitals with comprehensive electronic health record (EHR) systems, factors related to advanced system usability remain largely unknown, particularly among nurses. Little empirical research has examined sociotechnical factors, such as the work environment, that may shape the relationship between advanced EHR adoption and quality of care. The objective of this study was to examine the independent and joint effects of comprehensive EHR adoption and the hospital work environment on nurse reports of EHR usability and nurse-reported quality of care and safety. This study was a secondary analysis of nurse and hospital survey data. Unadjusted and adjusted logistic regression models were used to assess the relationship between EHR adoption level, work environment, and a set of EHR usability and quality/safety outcomes. The sample included 12,377 nurses working in 353 hospitals. In fully adjusted models, comprehensive EHR adoption was associated with lower odds of nurses reporting poor usability outcomes, such as dissatisfaction with the system (odds ratio [OR]: 0.75; 95% confidence interval [CI]: 0.61-0.92). The work environment was associated with all usability outcomes wit...Continue Reading

Citations

Feb 28, 2020·BMC Medical Informatics and Decision Making·Yvonne O'ConnorPhilip O'Reilly
Aug 22, 2020·Yearbook of Medical Informatics·Yalini SenathirajahUNKNOWN Section Editors for the IMIA Yearbook Section on Human Factors and Organizational Issues
Sep 10, 2020·Applied Clinical Informatics·Robert P PierceJeffery L Belden
May 29, 2019·The American Journal of Nursing·Karen Rosenberg
Apr 4, 2021·International Journal of Environmental Research and Public Health·Rebecca M JedwabBernice Redley
Feb 20, 2021·Journal of Nursing Measurement·Vanessa N BrunelliElizabeth C Schenk
May 27, 2021·Revista latino-americana de enfermagem·Neurilene Batista de Oliveira, Heloísa Helena Ciqueto Peres

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