What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providers

Objective To identify patient-safety-related unintended consequences of healthcare technologies experienced by their primary users: patients, carers and healthcare providers (HCPs).Design Qualitative study based on data collected in online focus groups. Transcripts were analysed inductively after ea...

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Main Authors: Carly Wheeler, Bryony Dean Franklin, Ana Luísa Neves, Sara Garfield, John Norton, Jackie van Dael, Monsey McLeod, Shahd Abdelaziz, Jill Lloyd
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/11/e089026.full
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author Carly Wheeler
Bryony Dean Franklin
Ana Luísa Neves
Sara Garfield
John Norton
Jackie van Dael
Monsey McLeod
Shahd Abdelaziz
Jill Lloyd
author_facet Carly Wheeler
Bryony Dean Franklin
Ana Luísa Neves
Sara Garfield
John Norton
Jackie van Dael
Monsey McLeod
Shahd Abdelaziz
Jill Lloyd
author_sort Carly Wheeler
collection DOAJ
description Objective To identify patient-safety-related unintended consequences of healthcare technologies experienced by their primary users: patients, carers and healthcare providers (HCPs).Design Qualitative study based on data collected in online focus groups. Transcripts were analysed inductively after each focus group using reflexive thematic analysis, focusing on identifying unintended consequences of healthcare technologies with implications for patient safety. Patient safety was broadly conceptualised to include a more subjective concept of ‘feeling safe’ as well as risks of actual harm.Setting Patient/public and HCP participants from the UK with experience in healthcare technologies were recruited using a mixture of purposive, convenience and snowball sampling.Participants 40 participants (29 patients/public, 11 HCPs) took part in 5 focus groups between November 2021 and February 2022.Results We identified five main themes of unintended consequences with implications for patient safety: inequity of access, increased end-user burden, loss of the human element of healthcare, over-reliance on technology and unclear responsibilities. Both groups of participants identified unintended consequences directly affecting patients; HCPs also described those affecting themselves. Some unintended consequences are described in previous literature, including alert fatigue, the ‘illusion of communication’, reduced opportunities for face-to-face interactions and increased end-user burden. Others are potentially novel, including patients’ psychological dependence on technologies, ‘gaming’ of data entry and incorrect interpretation of health data.Conclusions Drawing on the perspectives of patients/public as well as HCPs, we identified five areas of patient-safety-related unintended consequences associated with healthcare technologies. These should be considered when developing tools to identify and mitigate the patient-safety-related unintended consequences of healthcare technologies.
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spelling doaj-art-838f2a48cfd64f2baa8edcbd29d5dbe02025-08-20T02:38:49ZengBMJ Publishing GroupBMJ Open2044-60552024-11-01141110.1136/bmjopen-2024-089026What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providersCarly Wheeler0Bryony Dean Franklin1Ana Luísa Neves2Sara Garfield3John Norton4Jackie van Dael5Monsey McLeod6Shahd Abdelaziz7Jill Lloyd87 NHS England, London, UK2 UCL School of Pharmacy, London, UK3 Department of Primary Care and Public Health, Imperial College London, London, UK2 UCL School of Pharmacy, London, UK5 Patient Safety Translational Research Centre, Imperial College, London, UK6 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK7 NHS England, London, UK1 Pharmacy, Imperial College Healthcare NHS Trust, London, UK4 Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, UKObjective To identify patient-safety-related unintended consequences of healthcare technologies experienced by their primary users: patients, carers and healthcare providers (HCPs).Design Qualitative study based on data collected in online focus groups. Transcripts were analysed inductively after each focus group using reflexive thematic analysis, focusing on identifying unintended consequences of healthcare technologies with implications for patient safety. Patient safety was broadly conceptualised to include a more subjective concept of ‘feeling safe’ as well as risks of actual harm.Setting Patient/public and HCP participants from the UK with experience in healthcare technologies were recruited using a mixture of purposive, convenience and snowball sampling.Participants 40 participants (29 patients/public, 11 HCPs) took part in 5 focus groups between November 2021 and February 2022.Results We identified five main themes of unintended consequences with implications for patient safety: inequity of access, increased end-user burden, loss of the human element of healthcare, over-reliance on technology and unclear responsibilities. Both groups of participants identified unintended consequences directly affecting patients; HCPs also described those affecting themselves. Some unintended consequences are described in previous literature, including alert fatigue, the ‘illusion of communication’, reduced opportunities for face-to-face interactions and increased end-user burden. Others are potentially novel, including patients’ psychological dependence on technologies, ‘gaming’ of data entry and incorrect interpretation of health data.Conclusions Drawing on the perspectives of patients/public as well as HCPs, we identified five areas of patient-safety-related unintended consequences associated with healthcare technologies. These should be considered when developing tools to identify and mitigate the patient-safety-related unintended consequences of healthcare technologies.https://bmjopen.bmj.com/content/14/11/e089026.full
spellingShingle Carly Wheeler
Bryony Dean Franklin
Ana Luísa Neves
Sara Garfield
John Norton
Jackie van Dael
Monsey McLeod
Shahd Abdelaziz
Jill Lloyd
What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providers
BMJ Open
title What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providers
title_full What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providers
title_fullStr What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providers
title_full_unstemmed What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providers
title_short What are the unintended patient safety consequences of healthcare technologies? A qualitative study among patients, carers and healthcare providers
title_sort what are the unintended patient safety consequences of healthcare technologies a qualitative study among patients carers and healthcare providers
url https://bmjopen.bmj.com/content/14/11/e089026.full
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