Abstract Coordinating care across hospitals has been identified as a patient safety risk as referrals are often paper-based and poorly documented. Electronic referral systems have the potential to improve the situation but can fail to gain uptake. We applied a human factors/ergonomics (HFE) approach to place analysis of local workflow and user engagement central to the development of a new regional electronic referral system. The intervention was evaluated with a before-and-after study. Referral quality improved, referrals containing sufficient clinical information for continuation of care increased from 36.9% to 83.5% and completeness of referral information significantly improved. There was a 35.7% reduction in the number of calls to the on-call specialist, and the mean period between admission and surgery for expedited transfers was reduced. Applying HFE informed design with use-based evidence; the system maintains sustained uptake three years after implementation. Reliable recording of information translates to better patient safety during inter-hospital transitions. Practitioners summary: This study developed, implemented and evaluated a clinical referral system using a human factors approach. Process analysis and usability studies were used to inform the application requirements and design. Region-wide implementation in hospitals resulted in the improved quality and completeness of clinical referral information and efficiencies in the referral process.

中文翻译：

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电子医院转诊系统的开发和评估：人为因素方法

摘要 跨医院协调护理已被确定为患者安全风险，因为转诊通常是基于纸张的且记录不全。电子转诊系统有可能改善这种情况，但可能无法获得采纳。我们应用人为因素/人体工程学 (HFE) 方法对本地工作流程和用户参与进行分析，这是开发新的区域电子转诊系统的核心。干预是通过前后研究来评估的。转诊质量提高，转诊包含足够临床信息以继续治疗的比例从 36.9% 增加到 83.5%，转诊信息的完整性显着提高。呼叫待命专家的次数减少了 35.7%，并且缩短了入院和手术之间加急转诊的平均时间。使用基于使用的证据应用 HFE 知情设计；该系统在实施三年后保持持续吸收。可靠的信息记录可以在医院间转换期间提高患者的安全性。从业者总结：本研究使用人为因素方法开发、实施和评估了临床转诊系统。过程分析和可用性研究用于告知应用程序要求和设计。在医院的区域范围内实施提高了临床转诊信息的质量和完整性以及转诊过程的效率。从业者总结：本研究使用人为因素方法开发、实施和评估了临床转诊系统。过程分析和可用性研究用于告知应用程序要求和设计。在医院的区域范围内实施提高了临床转诊信息的质量和完整性以及转诊过程的效率。从业者总结：本研究使用人为因素方法开发、实施和评估了临床转诊系统。过程分析和可用性研究用于告知应用程序要求和设计。在医院的区域范围内实施提高了临床转诊信息的质量和完整性以及转诊过程的效率。