帮助我们记录我们已经做的事情:对临床决策支持工具的试点研究,以社会风险为导向的医疗保健为目标
Maura Pisciotta1, Suzanne Morrissey2, Arwen Bunce1
1OCHIN, Inc., Portland, OR 97228, United States.
JAMIA open
|June 2, 2025
概括
试点使用临床决策支持 (CDS) 工具,帮助护理团队解决患者的社会风险. 修订的重点是记录已经采取的行动,改善可用性和团队合作,以提供基于社会风险的护理.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持系统 临床决策支持系统
- 健康的社会决定因素
背景情况:
- 临床决策支持 (CDS) 工具对于将患者的社会风险纳入护理至关重要.
- 目前的CDS工具往往缺乏功能,以有效地支持护理团队解决社会风险.
- 了解用户需求对于优化CDS工具设计和实施至关重要.
研究的目的:
- 试点基于电子健康记录 (EHR) 的CDS工具,旨在支持基于社会风险的护理.
- 评估这些CDS工具在社区卫生中心的实际使用情况.
- 确定社会风险管理的CDS工具设计中需要改进的领域.
主要方法:
- 通过涉及诊所工作人员和患者参与的协作流程开发了CDS工具.
- 在三个社区卫生中心诊所实施了试点CDS工具.
- 通过员工采访,会议观察和EHR记录收集数据,以分析工具使用模式.
主要成果:
- 主要发现表明需要将CDS工具的重点从护理建议转移到记录临床团队已经采取的与社会风险相关的行动.
- 修订的关键见解包括促进标准化,简洁的文档.
- 还确定了提高文档的易用性和一致性,支持工作分配,并使多个文档目的成为可能.
结论:
- 经过修订的CDS工具证明了初级保健团队为具有社会风险的患者提供服务的更好的实用性和可接受性.
- 设计有效的CDS工具需要解决与不同诊所工作流程相关的挑战.
- 优化CDS工具可以提高基于社会风险的护理服务,同时最大限度地降低临床医生的负担.
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