Name
Title | ||
|---|---|---|
Informing the design of clinical decision support services for evaluation of children with minor blunt head trauma in the emergency department: a sociotechnical analysis. |
Abstract | ||
|---|---|---|
Integration of clinical decision support services (CDSS) into electronic health records (EHRs) may be integral to widespread dissemination and use of clinical prediction rules in the emergency department (ED). However, the best way to design such services to maximize their usefulness in such a complex setting is poorly understood. We conducted a multi-site cross-sectional qualitative study whose aim was to describe the sociotechnical environment in the ED to inform the design of a CDSS intervention to implement the Pediatric Emergency Care Applied Research Network (PECARN) clinical prediction rules for children with minor blunt head trauma. Informed by a sociotechnical model consisting of eight dimensions, we conducted focus groups, individual interviews and workflow observations in 11 EDs, of which 5 were located in academic medical centers and 6 were in community hospitals. A total of 126 ED clinicians, information technology specialists, and administrators participated. We clustered data into 19 categories of sociotechnical factors through a process of thematic analysis and subsequently organized the categories into a sociotechnical matrix consisting of three high-level sociotechnical dimensions (workflow and communication, organizational factors, human factors) and three themes (interdisciplinary assessment processes, clinical practices related to prediction rules, EHR as a decision support tool). Design challenges that emerged from the analysis included the need to use structured data fields to support data capture and re-use while maintaining efficient care processes, supporting interdisciplinary communication, and facilitating family-clinician interaction for decision-making. |
Year | DOI | Venue |
|---|---|---|
2013 | 10.1016/j.jbi.2013.07.005 | Journal of Biomedical Informatics |
Keywords | Field | DocType |
sociotechnical analysis,pediatrics,clinical decision support service,ed clinicians,cdss,emergency department,data field,minor blunt head trauma,computed tomography,sociotechnical factor,clinical decision support,tbi,ct,ed,high-level sociotechnical dimension,traumatic brain injury,clinical decision support services,sociotechnical matrix,prediction rules,clinical practice,sociotechnical environment,sociotechnical model,clinical prediction rule,suicide prevention,ergonomics,human factors,occupational safety,injury prevention | Thematic analysis,Data mining,Computer science,Emergency department,Decision support system,Sociotechnical system,Clinical decision support system,Qualitative research,Documentation,Workflow | Journal |
Volume | Issue | ISSN |
46 | 5 | 1532-0480 |
Citations | PageRank | References |
5 | 0.47 | 10 |
Authors | ||
18 | ||
Name | Order | Citations | PageRank |
|---|---|---|---|
| Barbara Sheehan | 1 | 8 | 2.46 |
| Lise E. Nigrovic | 2 | 5 | 1.15 |
| Dayan Peter S | 3 | 7 | 2.27 |
| Kuppermann Nathan | 4 | 7 | 1.59 |
| Ballard Dustin W | 5 | 5 | 0.81 |
| Alessandrini Evaline | 6 | 5 | 0.81 |
| Bajaj Lalit | 7 | 5 | 1.15 |
| Howard Goldberg | 8 | 47 | 9.41 |
| Jeffrey Hoffman | 9 | 9 | 2.32 |
| Offerman Steven R | 10 | 5 | 0.81 |
| Mark Dustin G | 11 | 5 | 0.47 |
| Swietlik Marguerite | 12 | 14 | 2.10 |
| Tham Eric | 13 | 7 | 1.59 |
| Tzimenatos Leah | 14 | 5 | 1.15 |
| Vinson David R | 15 | 7 | 1.87 |
| Jones Grant S | 16 | 5 | 0.47 |
| Suzanne Bakken | 17 | 612 | 111.65 |
| null null | 18 | 6391 | 656.33 |