J Am Med Inform Assoc - Governance for clinical decision support: case studies and recommended practices from leading institutions.

Tópicos

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Resumo

JECTIVE: Clinical decision support (CDS) is a powerful tool for improving healthcare quality and ensuring patient safety; however, effective implementation of CDS requires effective clinical and technical governance structures. The authors sought to determine the range and variety of these governance structures and identify a set of recommended practices through observational study.DESIGN: Three site visits were conducted at institutions across the USA to learn about CDS capabilities and processes from clinical, technical, and organizational perspectives. Based on the results of these visits, written questionnaires were sent to the three institutions visited and two additional sites. Together, these five organizations encompass a variety of academic and community hospitals as well as small and large ambulatory practices. These organizations use both commercially available and internally developed clinical information systems.MEASUREMENTS: Characteristics of clinical information systems and CDS systems used at each site as well as governance structures and content management approaches were identified through extensive field interviews and follow-up surveys.RESULTS: Six recommended practices were identified in the area of governance, and four were identified in the area of content management. Key similarities and differences between the organizations studied were also highlighted.CONCLUSION: Each of the five sites studied contributed to the recommended practices presented in this paper for CDS governance. Since these strategies appear to be useful at a diverse range of institutions, they should be considered by any future implementers of decision support.

Resumo Limpo

jectiv clinic decis support cds power tool improv healthcar qualiti ensur patient safeti howev effect implement cds requir effect clinic technic govern structur author sought determin rang varieti govern structur identifi set recommend practic observ studydesign three site visit conduct institut across usa learn cds capabl process clinic technic organiz perspect base result visit written questionnair sent three institut visit two addit site togeth five organ encompass varieti academ communiti hospit well small larg ambulatori practic organ use commerci avail intern develop clinic inform systemsmeasur characterist clinic inform system cds system use site well govern structur content manag approach identifi extens field interview followup surveysresult six recommend practic identifi area govern four identifi area content manag key similar differ organ studi also highlightedconclus five site studi contribut recommend practic present paper cds govern sinc strategi appear use divers rang institut consid futur implement decis support

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