The effect of computerized decision support on barriers to guideline implementation: A qualitative study in outpatient cardiac rehabilitation

2010 ◽  
Vol 79 (6) ◽  
pp. 430-437 ◽  
Author(s):  
Rick Goud ◽  
Mariette van Engen-Verheul ◽  
Nicolette F. de Keizer ◽  
Roland Bal ◽  
Arie Hasman ◽  
...  
Keyword(s):  
Decision Support ◽  
Qualitative Study ◽  
Cardiac Rehabilitation ◽  
Guideline Implementation ◽  
Computerized Decision Support

scholarly journals Users’ Assessement of the Visualization with Gauges of a Guideline-Based Decision Support System Output: A Qualitative Study of Focus Groups

2021 ◽  
Author(s):  
Abir Abdellatif ◽  
Jacques Bouaud ◽  
Mélissa Tholomier ◽  
Joël Belmin ◽  
Brigitte Seroussi
Keyword(s):  
Decision Support ◽  
Qualitative Study ◽  
Focus Groups ◽  
Pressure Ulcer ◽  
Clinical Practices ◽  
Computerized Decision Support ◽  
Usability Problems ◽  
System Output ◽  
Computerized Decision Support Systems

Computerized decision support systems (CDSSs) are still poorly routinely implemented in clinical practices mainly because of usability problems related to the technology interface. We previously proposed to use gauges to visualize the output of a guideline-based CDSS applied to malnutrition and pressure ulcer management in nursing homes. This interface was assessed by four focus groups including 16 healthcare professionals with expertise in geriatrics. A USE-like questionnaire was distributed. Participants considered the dashboard-with-gauges visualization was useful (94%), easy to use (63%), easy to learn (88%), and 88% thought they could be satisfied with it. However, concerns were expressed about the difficulty to follow up multiple healthcare problems.

scholarly journals Computer-supported Detection of M-Components and Evaluation of Immunoglobulins after Capillary Electrophoresis

2001 ◽  
Vol 47 (1) ◽  
pp. 110-117 ◽  
Author(s):  
Magnus Jonsson ◽  
Joyce Carlson ◽  
Jan-Olof Jeppsson ◽  
Per Simonsson
Keyword(s):  
Capillary Electrophoresis ◽  
Decision Support ◽  
Protein Separation ◽  
Serum Proteins ◽  
Cost Effective ◽  
Clinical Samples ◽  
Serum Samples ◽  
Computerized Decision Support ◽  
Cost Effective Method ◽  
Mathematical Algorithms

Abstract Background: Electrophoresis of serum samples allows detection of monoclonal gammopathies indicative of multiple myeloma, Waldenström macroglobulinemia, monoclonal gammopathy of undetermined significance, and amyloidosis. Present methods of high-resolution agarose gel electrophoresis (HRAGE) and immunofixation electrophoresis (IFE) are manual and labor-intensive. Capillary zone electrophoresis (CZE) allows rapid automated protein separation and produces digital absorbance data, appropriate as input for a computerized decision support system. Methods: Using the Beckman Paragon CZE 2000 instrument, we analyzed 711 routine clinical samples, including 95 monoclonal components (MCs) and 9 cases of Bence Jones myeloma, in both the CZE and HRAGE systems. Mathematical algorithms developed for the detection of monoclonal immunoglobulins (MCs) in the γ- and β-regions of the electropherogram were tested on the entire material. Additional algorithms evaluating oligoclonality and polyclonal concentrations of immunoglobulins were also tested. Results: CZE electropherograms corresponded well with HRAGE. Only one IgG MC of 1 g/L, visible on HRAGE, was not visible after CZE. Algorithms detected 94 of 95 MCs (98.9%) and 100% of those visible after CZE. Of 607 samples lacking an MC on HRAGE, only 3 were identified by the algorithms (specificity, 99%). Algorithms evaluating total gammaglobulinemia and oligoclonality also identified several cases of Bence Jones myeloma. Conclusions: The use of capillary electrophoresis provides a modern, rapid, and cost-effective method of analyzing serum proteins. The additional option of computerized decision support, which provides rapid and standardized interpretations, should increase the clinical availability and usefulness of protein analyses in the future.

scholarly journals A Qualitative Study on the US Forest Service’s Risk Management Assistance Efforts to Improve Wildfire Decision-Making

Forests ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 344
Author(s):  
Courtney A. Schultz ◽  
Lauren F. Miller ◽  
Sarah Michelle Greiner ◽  
Chad Kooistra
Keyword(s):  
Decision Making ◽  
Risk Management ◽  
Decision Support ◽  
Qualitative Study ◽  
Fire Management ◽  
Perceived Value ◽  
Forest Service ◽  
The Us ◽  
Decision Biases ◽  
Line Officers

To support improved wildfire incident decision-making, in 2017 the US Forest Service (Forest Service) implemented risk-informed tools and processes, together known as Risk Management Assistance (RMA). The Forest Service is developing tools such as RMA to improve wildfire decision-making and implements these tools in complex organizational environments. We assessed the perceived value of RMA and factors that affected its use to inform the literature on decision support for fire management. We sought to answer two questions: (1) What was the perceived value of RMA for line officers who received it?; and (2) What factors affected how RMA was received and used during wildland fire events? We conducted a qualitative study involving semi-structured interviews with decision-makers to understand the contextualized and interrelated factors that affect wildfire decision-making and the uptake of a decision-support intervention such as RMA. We used a thematic coding process to analyze our data according to our questions. RMA increased line officers’ ability to communicate the rationale underlying their decisions more clearly and transparently to their colleagues and partners. Our interviewees generally said that RMA data analytics were valuable but did not lead to changes in their decisions. Line officer personality, pre-season exposure to RMA, local political dynamics and conditions, and decision biases affected the use of RMA. Our findings reveal the complexities of embracing risk management, not only in the context of US federal fire management, but also in other similar emergency management contexts. Attention will need to be paid to existing decision biases, integration of risk management approaches in the interagency context, and the importance of knowledge brokers to connect across internal organizational groups. Our findings contribute to the literature on managing change in public organizations, specifically in emergency decision-making contexts such as fire management.

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