Using formative evaluation to improve uptake of a web-based tool to support antimicrobial stewardship

Area of Science:

• Health Informatics
• Clinical Decision Support Systems
• Medical Software Implementation

Background:

• Web-based decision support tools aid antimicrobial stewardship.
• Clinician acceptance is crucial for the success of these tools.
• This study assessed the impact of formative evaluation on antibiotic CDSS uptake.

Purpose of the Study:

• To evaluate how formative evaluation influences clinician adoption of a web-based antibiotic computerized decision support system (CDSS).
• To identify barriers to CDSS use and inform system improvements.

Main Methods:

• Conducted semi-structured qualitative interviews with 42 junior and senior doctors and pharmacists.
• Analyzed interview transcripts to identify barriers to CDSS use.
• Generated automated logs of CDSS usage before and after formative evaluation.

Main Results:

• Identified content and implementation strategy barriers to CDSS use.
• Observed differences between junior and senior doctors regarding antibiotic restriction strategies.
• Formative evaluation led to significant system modifications and increased CDSS uptake.

Conclusions:

• Formative evaluation enhanced clinician uptake of the antibiotic CDSS.
• Recommends formative evaluation as a standard strategy for implementing future CDSS and clinical computing applications.