确定在医院成功实施计算机化临床决策支持系统的障碍和促进因素:一个基于NASSS框架的范围审查
Bridget Abell1, Sundresan Naicker2, David Rodwell1
1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
Implementation science : IS
|July 26, 2023
概括
在医院中实施计算机化临床决策支持系统 (CDSS) 面临挑战. 该NASSS框架有助于识别成功采用和使用CDSS的障碍和促进因素.
科学领域:
- 医疗信息学 医疗信息学
- 实施科学 实施科学
背景情况:
- 在医院实施计算机化临床决策支持系统 (CDSS) 是复杂的.
- 实施科学,特别是NASSS框架,提供了一种系统的方法来应对这些挑战.
研究的目的:
- 识别,分类和描述在医院中实施CDSS的障碍和促进者.
- 将这些决定因素映射到NASSS框架中,并探索其适用于CDSS实施的可能性.
主要方法:
- 进行了全面的电子数据库搜索 (MEDLINE,Embase,Scopus,PyscInfo,CINAHL),更新时间为2022年4月.
- 包括关于CDSS障碍/医院辅助者的原始研究,不包括以发展为重点的文章.
- 利用定性内容分析来识别决定因素并将它们映射到NASS框架中.
主要成果:
- 分析了44个出版物,确定了227个障碍和130个促进CDSS实施的方便者.
- 关键影响因素包括工作流适应性,输出实用性,技术依赖性,用户信任性和上下文适应性.
- 大多数决定因素映射到NASSS领域:技术,组织和采用者;没有一个适合"随着时间的推移嵌入和适应".
结论:
- 确定了CDSS实施的共同决定因素,可以针对其进行修改.
- 建议更多地采用实施理论,以提高CDSS在医院的实施成功.
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