The Use of Clinical Systems to Improve Outcomes and Efficiencies Essay

The Use of Clinical Systems to Improve Outcomes and Efficiencies Essay

Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

A clinical decision support system (CDSS) is a tool that leverages information technologies and is available to health care providers with a focus on improving health care delivery. In fact, CDSS enhances medical decisions by targeting health information to include patient information and clinical knowledge. There is much potential for use of CDSS in achieving improved outcomes and efficiencies (Sutton et al., 2020). This paper presents an annotated bibliography that offers description, criticism and evaluation of four scholarly publications that contribute to evidence on CDSS, and act as a springboard for further research into the use of CDSS as a clinical system for improving outcomes and efficiencies. The Use of Clinical Systems to Improve Outcomes and Efficiencies Essay

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Annotated bibliography

Tao, L., Zhang, C., Zeng, L., Zhu, S., Li, N., Li, W., … & Ji, H. (2020). Accuracy and Effects of Clinical Decision Support Systems Integrated With BMJ Best Practice–Aided Diagnosis: Interrupted Time Series Study. JMIR Medical Informatics, 8(1), e16912. https://doi.org/10.2196/16912

This journal article presents the results of a study into the accuracy and effects of CDSS integrated with best practices. The authors note that CDSS has become an integrated component of health information technologies, and is useful in interpreting diseases, diagnosis, treatment and prognosis. However, it is noted that CDSS utility attracts some controversy over its accuracy. As such, the study sought to assess how integrated British Medical Journal (BMJ) best practices into CDSS affects outcomes. The results of the study reveals that CDSS significantly improves diagnosis accuracy, reduces diagnosis time, and reduces hospitalization days. Additional analysis based on interrupted time series revealed that although integrating BMJ best practices into CDSS significantly improved diagnosis accuracy, it did not have a significant effect on hospitalization days when compared to CDSS used in isolation. This journal article is useful for showing that implementing CDSS integrated with best evidence is useful for improving diagnosis accuracy, reducing diagnosis time, and reducing hospitalization days.

Olakotan, O. O., & Yusof, M. M. (2021). The appropriateness of clinical decision support systems alerts in supporting clinical workflows: A systematic review. Health Informatics Journal, 27(2). https://doi.org/10.1177/14604582211007536 The Use of Clinical Systems to Improve Outcomes and Efficiencies Essay

This journal article explores the appropriateness of CDSS alerts in supporting the clinical workflows. Applying a secondary research approach that explores previous publications, the CDSS is not intelligent enough to only generate appropriate alerts. Many of the alerts are not appropriate and up interfering with the clinical workflows so that clinicians develop a habit of ignoring the alerts and compromising patient safety. Given this awareness and based on the systematic review results, the authors suggest that technology, human, organization and process factors should be considered in developing the algorithms for determining the CDSS alerts to be communicated to clinicians. This journal article offers useful insight into the factors that must be taken into consideration when designing appropriate CDSS alerts that support clinical workflows.  The Use of Clinical Systems to Improve Outcomes and Efficiencies Essay

Mebrahtu, T. F., Skyrme, S., Randell, R., Keenan, A. M., Bloor, K., Yang, H., … & Thompson, C. (2021). Effects of computerised clinical decision support systems (CDSS) on nursing and allied health professional performance and patient outcomes: a systematic review of experimental and observational studies. BMJ Open, 11(12), e053886. https://doi.org/10.1136/bmjopen-2021-053886

This journal article explores the effects of CDSS on clinicians’ performance and patient outcomes. The authors note that CDSS has become an increasingly common tool in health care delivery. However, there is a need to understand how CDSS affects the performance of health care professionals and outcomes for patients. Applying a systematic review approach that explored previous publications, the study reported that CDSS positively affects outcome measures, care processes adoption, and patient outcomes. Despite the positive impact of CDSS as reported in previous studies, the authors caution that a better quality comparative research study is required to better understand the effects of CDSS. This journal article identifies a gap in CDSS knowledge, showing that the impact of CDSS cannot be generalized for all practice such that each practice may have different effects.

Lopez, K. D., Gephart, S. M., Raszewski, R., Sousa, V., Shehorn, L. E., & Abraham, J. (2017). Integrative review of clinical decision support for registered nurses in acute care settings. Journal of the American Medical Informatics Association, 24(2), 441–450. https://doi.org/10.1093/jamia/ocw084

This journal article presents the results of an integrative review on CDSS use by nurses in acute care setting. The authors report on the state CDSS science as applied by hospital bedside nurses. The authors report that CDSS has no negative effects, and instead has positive effects on patient outcomes, usability and process. The article concedes that CDSS positively affects nursing outcomes and care quality. However, the evidence is faulted for failing to explore the effects of CDSS in terms of volume and level of evidence. This article is useful for identifying new research focus areas for CDSS. The Use of Clinical Systems to Improve Outcomes and Efficiencies Essay

Conclusion

CDSS is presented as a tool that supports medical personnel in providing care and improving outcomes. In fact, CDSS is useful for improving diagnosis accuracy, reducing diagnosis time, and reducing hospitalization days. Although CDSS is useful, technology, human, organization and process factors should be considered in improving CDSS usefulness and value. In addition, the literature explores reveals that CDSS effects are bets understood in comparative studies, and that greater volume of evidence is needed to verify the effects of CDSS.

 

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References

Lopez, K. D., Gephart, S. M., Raszewski, R., Sousa, V., Shehorn, L. E., & Abraham, J. (2017). Integrative review of clinical decision support for registered nurses in acute care settings. Journal of the American Medical Informatics Association, 24(2), 441–450. https://doi.org/10.1093/jamia/ocw084

Mebrahtu, T. F., Skyrme, S., Randell, R., Keenan, A. M., Bloor, K., Yang, H., … & Thompson, C. (2021). Effects of computerised clinical decision support systems (CDSS) on nursing and allied health professional performance and patient outcomes: a systematic review of experimental and observational studies. BMJ Open, 11(12), e053886. https://doi.org/10.1136/bmjopen-2021-053886

Olakotan, O. O., & Yusof, M. M. (2021). The appropriateness of clinical decision support systems alerts in supporting clinical workflows: A systematic review. Health Informatics Journal, 27(2). https://doi.org/10.1177/14604582211007536

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: benefits, risks, and strategies for success. npj Digital Medicine, 3, Article number 17. https://doi.org/10.1038/s41746-020-0221-y

Tao, L., Zhang, C., Zeng, L., Zhu, S., Li, N., Li, W., … & Ji, H. (2020). Accuracy and Effects of Clinical Decision Support Systems Integrated With BMJ Best Practice–Aided Diagnosis: Interrupted Time Series Study. JMIR Medical Informatics, 8(1), e16912. https://doi.org/10.2196/16912 The Use of Clinical Systems to Improve Outcomes and Efficiencies Essay

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies. Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking. In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings. To Prepare: Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery. Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.” Identify and select 4 peer-reviewed research articles from your research. For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies The Assignment: (4-5 pages not including the title and reference page) In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following: Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format. Include an introduction explaining the purpose of the paper. Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples. In your conclusion, synthesize the findings from the 4 peer-reviewed research articles. Use APA format and include a title page. Use the Safe Assign Drafts to check your match percentage before submitting your work. The Use of Clinical Systems to Improve Outcomes and Efficiencies Essay

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