Abstract: |
Background:
Clinical decision support systems (CDSS) are integral to modern healthcare, providing timely information through alerts to aid healthcare providers. However, challenges such as alert fatigue and alert overrides significantly impede their effectiveness. The research context delves into the multifaceted factors affecting CDSS performance, encompassing technology, human factors, organizational aspects, and process considerations, scrutinized through the socio-technical framework. Medication-related alerts, vital for ensuring patient adherence, grapple with issues like frequent overrides and low clinical value.
Research significance/importance:
The research underscores the paramount significance of specificity and sensitivity within CDSS alerts, particularly in hospital settings. In healthcare, challenges abound, ranging from the intricacies of alert design and the management of alert fatigue to the delicate task of harmonizing specificity and sensitivity. These challenges permeate the healthcare landscape, exerting influences on patient care, increasing the burdens on healthcare providers, and introducing potential risks of adverse outcomes. Achieving a nuanced equilibrium between specificity and sensitivity within CDSS is crucial, considering unique healthcare requirements and patient characteristics.
Proposed solutions and potential contributions:
The research proposes tailored interventions, from alert deactivation to leveraging contextual information, emphasizing context-specific data and the role of well-designed order entry systems. Recommendations span standardizing alert criteria, periodic system assessments, and meticulous investigations into factors influencing ADEs. The research advocates for a comprehensive, multifaceted approach considering technological enhancements, human factors, organizational adjustments, and refined processes to enhance CDSS specificity and sensitivity.
Practical contributions manifest through integrating research findings into a structured framework and mapping factors onto the HOT-fit framework for optimization. The ultimate objective is the prevention of ADEs, requiring thorough documentation related to clinical justification for alert overrides and rule revisions and acknowledging the cross-disciplinary significance of specificity and sensitivity and ongoing refinement in alert design and monitoring. Researchers and healthcare professionals unite to address these challenges, striving for enhanced CDSS efficacy and improved patient outcomes. |