Discussion Problem:
Characteristics and Elements of a Successful Clinical Decision Support Team
Builders should understand:
The clinical relevance of the care that CDS addresses and Relevant workflows and processes.
Disconnects occurring due to the language barrier in understanding healthcare-specific terminology must be eliminated.
The end user must experience a seamless and unobtrusive process.
Frameworks for Success
The "10 commandments" for success framework includes:
Recommendations on timeliness, end-user needs, addressing resistance,
Simplicity, monitoring impact, and managing the system based on the evidence
CDS encompasses a wide variety of tools such as:
Computerized alerts, drug-drug interaction alerts, under-dose or overdose alerts,
Actionable clinical guidelines, condition-specific order sets, and focused patient data reports.
Population-specific data, for example, micro-biograms, which are tables of local bacterial flora and their sensitivity and susceptibility to various antibiotics, can be used for CDS.
Federal agencies such as Office of the National Coordinator (ONC) and the Agency for Healthcare Research and Quality (AHRQ) main) could be used to:
Leverage the information and Either pull the information on-demand or download information on a routine basis.
Considering the four case studies presented, let us outline the life cycle intervention for each of the programs and consider the following question:
In examining the four case studies [chapter 19], Which interventions were most effective,the and how effective were they? Support your position with evaluation measures noted in each of the case studies. Are they qualitative or quantitative approaches? Could the team have improved its evaluation strategies? If so, how? If not, why not?
For your reference:
Chapter 19 explains the clinical decision support (CDS) programs and states the five rights frameworks that aid in its accomplishment. CDS is described as a set of tools to develop decision-making in the clinical workflow encompassing advanced methodologies such as predictive analytics, prescriptive analytics, and structured methodologies for promoting interoperability programs and improving cardiovascular health outcomes.
The challenges and complications associated with inappropriate usage of CDS that may lead to potential patient safety and legal implications for organizations raise the need to design CDS strategies to improve interventions and patient outcomes. The importance of including departments that support optimizing the overall impact of the CDS intervention on patient safety and quality has been emphasized and reviewed with important steps and concerns with liability for clinicians and hospitals.
We will be discussing several case studies that provide strategies for bringing specific CDS performance improvement into organizations that have also been stated.
CDS is an effective tool for improving adherence to clinical initiatives such as deep vein thrombosis (DVT) prophylaxis, cardiac mortality prevention strategies outlined in the Million Hearts campaign, and areas associated with the regulatory reporting requirements of quality measures.
The five rights address the who, what, where, when, and how of a CDS program while emphasizing the importance of clear articulation of goals and objectives that identify all five components.
The National Library of Medicine (NLM)maintains the Value Set Authority Center (VSAC) repository and includes clinical vocabularies such as SNOMed, RxNorm, and Loinc.
The Office of the National Coordinator (ONC) and the MITRE corporation shift content from narrative to structure in an attempt to keep CDS evidence-based.
The Institute of Medicine (IOM)report Health IT and Patient Safety: Building Safer Systems for Better Care outlines several relevant recommendations as to what constitutes safety from an end-user standpoint.