Identification of Design Criteria to Improve Patient Care in Electronic Health Record Downtime

J Patient Saf. 2021 Mar 1;17(2):90-94. doi: 10.1097/PTS.0000000000000580.


Objective: Design criteria specifications (needs, obstacles, and context-of-use considerations) for continuing safe and efficient patient care activities during downtime were identified by using phenomenological analysis.

Methods: Interview transcripts from medical personnel who had experience with downtime incidents were examined using a phenomenological approach. This process allowed for the identification of design criteria for performing downtime patient care activities.

Results: A substantial variation in criteria was found from participants in different roles. The differences suggest opportunities to address downtime that may require attention to individual roles.

Conclusions: Workload distribution and communication are significant issues in patient care during downtime. There may not be an equal work distribution, leading to an increased workload for some personnel during downtime. Phenomenological analysis was completed after participants were interviewed, indicating it is a viable post hoc approach. Some downtime criteria were identified as potential guidelines for the development of better downtime contingency plans.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Delivery of Health Care / methods*
  • Electronic Health Records / standards*
  • Humans
  • Patient Care / methods*