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Clinical informatics case study. Computerized protocols for ventilator management in ARDS patients. Case study.

L K Heermann1, C B Thompson, T D East

  • 1University of Utah College of Nursing, Salt Lake City 84112-5880, USA.

Computers in Nursing
|December 28, 1999
PubMed
Summary
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Implementing computerized mechanical ventilation protocols was largely successful. Key strategies included early IT engagement, comprehensive training, and creating super-users for better clinical decision support system adoption.

Area of Science:

  • Medical Informatics
  • Clinical Decision Support
  • Mechanical Ventilation

Background:

  • Computerized protocols can aid mechanical ventilation management.
  • Successful implementation is crucial for effective clinical decision support systems.
  • Previous studies offer insights into system implementation strategies.

Purpose of the Study:

  • To evaluate the success of implementing a computerized protocol for mechanical ventilation management across multiple clinical sites.
  • To identify factors contributing to successful and unsuccessful implementation of clinical decision support systems.
  • To differentiate between factors for successful trial evaluation and successful system use.

Main Methods:

  • A computerized protocol for mechanical ventilation management was implemented at 11 clinical sites.

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  • Implementation success was assessed based on site experiences and system usage.
  • Qualitative factors, including personnel buy-in and training, were analyzed.
  • Comparison with established implementation methodologies (e.g., Whitten, Bentley) was performed.

    • Main Results:

    • The overall implementation was considered successful, with 7 out of 11 sites encountering minimal difficulties.
    • One site experienced implementation failure due to software integration issues and loss of trust.
    • Three sites had minimal system usage, attributed to study time demands rather than system rejection.
    • Successful implementation strategies included early IT collaboration, key personnel buy-in, and robust training programs, including "super-user" roles.

    Conclusions:

    • Computerized mechanical ventilation protocol implementation can be successful with appropriate strategies.
    • Early engagement with IT, comprehensive training, and user support are critical for adoption.
    • Research-specific time requirements must be factored into clinical trial planning for decision support systems.