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A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory

(1) Background: The five rights of clinical decision support (CDS) are a well-known framework for planning the nuances of CDS, but recent advancements have given us more options to modify the format of the alert. One-size-fits-all assessments fail to capture the nuance of different BestPractice Advi...

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Autores principales: Douthit, Brian J., Musser, R. Clayton, Lytle, Kay S., Richesson, Rachel L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712422/
https://www.ncbi.nlm.nih.gov/pubmed/32977564
http://dx.doi.org/10.3390/jpm10040142
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author Douthit, Brian J.
Musser, R. Clayton
Lytle, Kay S.
Richesson, Rachel L.
author_facet Douthit, Brian J.
Musser, R. Clayton
Lytle, Kay S.
Richesson, Rachel L.
author_sort Douthit, Brian J.
collection PubMed
description (1) Background: The five rights of clinical decision support (CDS) are a well-known framework for planning the nuances of CDS, but recent advancements have given us more options to modify the format of the alert. One-size-fits-all assessments fail to capture the nuance of different BestPractice Advisory (BPA) formats. To demonstrate a tailored evaluation methodology, we assessed a BPA after implementation of Storyboard for changes in alert fatigue, behavior influence, and task completion; (2) Methods: Data from 19 weeks before and after implementation were used to evaluate differences in each domain. Individual clinics were evaluated for task completion and compared for changes pre- and post-redesign; (3) Results: The change in format was correlated with an increase in alert fatigue, a decrease in erroneous free text answers, and worsened task completion at a system level. At a local level, however, 14% of clinics had improved task completion; (4) Conclusions: While the change in BPA format was correlated with decreased performance, the changes may have been driven primarily by the COVID-19 pandemic. The framework and metrics proposed can be used in future studies to assess the impact of new CDS formats. Although the changes in this study seemed undesirable in aggregate, some positive changes were observed at the level of individual clinics. Personalized implementations of CDS tools based on local need should be considered.
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spelling pubmed-77124222020-12-04 A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory Douthit, Brian J. Musser, R. Clayton Lytle, Kay S. Richesson, Rachel L. J Pers Med Article (1) Background: The five rights of clinical decision support (CDS) are a well-known framework for planning the nuances of CDS, but recent advancements have given us more options to modify the format of the alert. One-size-fits-all assessments fail to capture the nuance of different BestPractice Advisory (BPA) formats. To demonstrate a tailored evaluation methodology, we assessed a BPA after implementation of Storyboard for changes in alert fatigue, behavior influence, and task completion; (2) Methods: Data from 19 weeks before and after implementation were used to evaluate differences in each domain. Individual clinics were evaluated for task completion and compared for changes pre- and post-redesign; (3) Results: The change in format was correlated with an increase in alert fatigue, a decrease in erroneous free text answers, and worsened task completion at a system level. At a local level, however, 14% of clinics had improved task completion; (4) Conclusions: While the change in BPA format was correlated with decreased performance, the changes may have been driven primarily by the COVID-19 pandemic. The framework and metrics proposed can be used in future studies to assess the impact of new CDS formats. Although the changes in this study seemed undesirable in aggregate, some positive changes were observed at the level of individual clinics. Personalized implementations of CDS tools based on local need should be considered. MDPI 2020-09-23 /pmc/articles/PMC7712422/ /pubmed/32977564 http://dx.doi.org/10.3390/jpm10040142 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Douthit, Brian J.
Musser, R. Clayton
Lytle, Kay S.
Richesson, Rachel L.
A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory
title A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory
title_full A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory
title_fullStr A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory
title_full_unstemmed A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory
title_short A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory
title_sort closer look at the “right” format for clinical decision support: methods for evaluating a storyboard bestpractice advisory
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712422/
https://www.ncbi.nlm.nih.gov/pubmed/32977564
http://dx.doi.org/10.3390/jpm10040142
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