Assessing the relationship between patient safety culture and EHR strategy

Eric W. Ford, Geoffrey A. Silvera, Abby S. Kazley, Mark L. Diana, Timothy R. Huerta

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose – The purpose of this paper is to explore the relationship between hospitals’ electronic health record (EHR) adoption characteristics and their patient safety cultures. The “Meaningful Use” (MU) program is designed to increase hospitals’ adoption of EHR, which will lead to better care quality, reduce medical errors, avoid unnecessary cost, and promote a patient safety culture. To reduce medical errors, hospital leaders have been encouraged to promote safety cultures common to high-reliability organizations. Expecting a positive relationship between EHR adoption and improved patient safety cultures appears sound in theory, but it has yet to be empirically demonstrated. Design/methodology/approach – Providers’ perceptions of patient safety culture and counts of patient safety incidents are explored in relationship to hospital EHR adoption patterns. Multi-level modeling is employed to data drawn from the Agency for Healthcare Research and Quality’s surveys on patient safety culture (level 1) and the American Hospital Association’s survey and healthcare information technology supplement (level 2). Findings – The findings suggest that the early adoption of EHR capabilities hold a negative association to the number of patient safety events reported. However, this relationship was not present in providers’ perceptions of overall patient safety cultures. These mixed results suggest that the understanding of the EHR-patient safety culture relationship needs further research. Originality/value – Relating EHR MU and providers’ care quality attitudes is an important leading indicator for improved patient safety cultures. For healthcare facility managers and providers, the ability to effectively quantify the impact of new technologies on efforts to change organizational cultures is important for pinpointing clinical areas for process improvements.

Original languageEnglish (US)
Pages (from-to)614-627
Number of pages14
JournalInternational Journal of Health Care Quality Assurance
Issue number6
StatePublished - Jul 11 2016


  • Electronic health record
  • Employee involvement
  • High-reliability organizations
  • Improvement models
  • Information management
  • Information technology
  • Key performance indicators
  • Meaningful use
  • Organizational culture
  • Patient safety

ASJC Scopus subject areas

  • Health Policy


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