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Designing clinical guidelines that improve access and satisfaction in the emergency department

Clinical guidelines are evidence‐based clinician decision‐support tools that improve health outcomes, reduce patient harm, and decrease healthcare costs, but are often underused in emergency departments (EDs). This article describes a replicable, evidence‐based design‐thinking approach to developing...

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Detalles Bibliográficos
Autores principales: Pondicherry, Neha, Schwartz, Hope, Stark, Nicholas, Dhanoa, Jaskirat, Emanuels, David, Singh, Malini, Peabody, Christopher R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9990158/
https://www.ncbi.nlm.nih.gov/pubmed/36896019
http://dx.doi.org/10.1002/emp2.12919
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author Pondicherry, Neha
Schwartz, Hope
Stark, Nicholas
Dhanoa, Jaskirat
Emanuels, David
Singh, Malini
Peabody, Christopher R.
author_facet Pondicherry, Neha
Schwartz, Hope
Stark, Nicholas
Dhanoa, Jaskirat
Emanuels, David
Singh, Malini
Peabody, Christopher R.
author_sort Pondicherry, Neha
collection PubMed
description Clinical guidelines are evidence‐based clinician decision‐support tools that improve health outcomes, reduce patient harm, and decrease healthcare costs, but are often underused in emergency departments (EDs). This article describes a replicable, evidence‐based design‐thinking approach to developing best practices for guideline design that improves clinical satisfaction and usage. We used a 5‐step process to enhance guideline usability in our ED. First, we conducted end‐user interviews to identify barriers to guideline usage. Second, we reviewed the literature to identify key principles in guideline design. Third, we applied our findings to create a standardized guideline format, incorporating rapid cycle learning and iterative improvements. Fourth, we ensured the clinical validity of our updated guidelines by using a rigorous process for peer review. Lastly, we evaluated the impact of our guideline conversion process by tracking clinical guidelines access per day from October 2020 to January 2022. Our end‐user interviews and review of the design literature revealed several barriers to guideline use, including lack of readability, design inconsistencies, and guideline complexity. Although our previous clinical guideline system averaged 0.13 users per day, >43 users per day accessed the clinical guidelines on our new digital platform in January 2022, representing an increase in access and use exceeding 33,000%. Our replicable process using open‐access resources increased clinician access to and satisfaction with clinical guidelines in our ED. Design‐thinking and use of low‐cost technology can significantly improve clinical guideline visibility and has the potential to increase guideline use.
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spelling pubmed-99901582023-03-08 Designing clinical guidelines that improve access and satisfaction in the emergency department Pondicherry, Neha Schwartz, Hope Stark, Nicholas Dhanoa, Jaskirat Emanuels, David Singh, Malini Peabody, Christopher R. J Am Coll Emerg Physicians Open Evidence‐Based Emergency Medicine Clinical guidelines are evidence‐based clinician decision‐support tools that improve health outcomes, reduce patient harm, and decrease healthcare costs, but are often underused in emergency departments (EDs). This article describes a replicable, evidence‐based design‐thinking approach to developing best practices for guideline design that improves clinical satisfaction and usage. We used a 5‐step process to enhance guideline usability in our ED. First, we conducted end‐user interviews to identify barriers to guideline usage. Second, we reviewed the literature to identify key principles in guideline design. Third, we applied our findings to create a standardized guideline format, incorporating rapid cycle learning and iterative improvements. Fourth, we ensured the clinical validity of our updated guidelines by using a rigorous process for peer review. Lastly, we evaluated the impact of our guideline conversion process by tracking clinical guidelines access per day from October 2020 to January 2022. Our end‐user interviews and review of the design literature revealed several barriers to guideline use, including lack of readability, design inconsistencies, and guideline complexity. Although our previous clinical guideline system averaged 0.13 users per day, >43 users per day accessed the clinical guidelines on our new digital platform in January 2022, representing an increase in access and use exceeding 33,000%. Our replicable process using open‐access resources increased clinician access to and satisfaction with clinical guidelines in our ED. Design‐thinking and use of low‐cost technology can significantly improve clinical guideline visibility and has the potential to increase guideline use. John Wiley and Sons Inc. 2023-03-07 /pmc/articles/PMC9990158/ /pubmed/36896019 http://dx.doi.org/10.1002/emp2.12919 Text en © 2023 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Evidence‐Based Emergency Medicine
Pondicherry, Neha
Schwartz, Hope
Stark, Nicholas
Dhanoa, Jaskirat
Emanuels, David
Singh, Malini
Peabody, Christopher R.
Designing clinical guidelines that improve access and satisfaction in the emergency department
title Designing clinical guidelines that improve access and satisfaction in the emergency department
title_full Designing clinical guidelines that improve access and satisfaction in the emergency department
title_fullStr Designing clinical guidelines that improve access and satisfaction in the emergency department
title_full_unstemmed Designing clinical guidelines that improve access and satisfaction in the emergency department
title_short Designing clinical guidelines that improve access and satisfaction in the emergency department
title_sort designing clinical guidelines that improve access and satisfaction in the emergency department
topic Evidence‐Based Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9990158/
https://www.ncbi.nlm.nih.gov/pubmed/36896019
http://dx.doi.org/10.1002/emp2.12919
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