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...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-09-01
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| Series: | Journal of Personalized Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4426/10/4/142 |
| _version_ | 1797552841925066752 |
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| author | Brian J. Douthit R. Clayton Musser Kay S. Lytle Rachel L. Richesson |
| author_facet | Brian J. Douthit R. Clayton Musser Kay S. Lytle Rachel L. Richesson |
| author_sort | Brian J. Douthit |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-10T16:06:44Z |
| format | Article |
| id | doaj.art-80c6f4cf5004434280c64289af5c9d58 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T16:06:44Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-80c6f4cf5004434280c64289af5c9d582023-11-20T14:48:49ZengMDPI AGJournal of Personalized Medicine2075-44262020-09-0110414210.3390/jpm10040142A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice AdvisoryBrian J. Douthit0R. Clayton Musser1Kay S. Lytle2Rachel L. Richesson3School of Nursing, Duke University, Durham, NC 27710, USASchool of Medicine, Duke University, Durham, NC 27710, USADuke Health, Duke School of Medicine, Durham, NC 27710 USASchool of Nursing, Duke University, Durham, NC 27710, USA(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.https://www.mdpi.com/2075-4426/10/4/142clinical decision supportsystems evaluationalert fatigue |
| spellingShingle | Brian J. Douthit R. Clayton Musser Kay S. Lytle Rachel L. Richesson A Closer Look at the “Right” Format for Clinical Decision Support: Methods for Evaluating a Storyboard BestPractice Advisory Journal of Personalized Medicine clinical decision support systems evaluation alert fatigue |
| 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 | clinical decision support systems evaluation alert fatigue |
| url | https://www.mdpi.com/2075-4426/10/4/142 |
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