Projects
Clinical Decision Support in Community Hospitals: Barriers and Facilitators
2009-2011
National Library of Medicine
Total award $400,000
PI: Dean Sittig
Project Description
Clinical decision support is key to computerized provider order entry success and safer, more efficient health care. Research at leading academic health centers indicates that when computerized provider order entry (CPOE) is coupled with clinical decision support (CDS), medical errors may decrease and costs drop. However, CPOE with CDS is not used in most community hospitals, which account for approximately 96% of all U.S. hospitals. This gap in CDS implementation between community and teaching hospitals portends serious consequences for health care quality, patient safety, and rising costs. This revised proposal outlines three aims, within a systems theory framework, to investigate CDS in community hospitals, and to collect and disseminate knowledge about what does and does not work. Research questions are 1) What are barriers to and facilitators for use of different types of CDS in community hospitals? 2) What strategies have community hospitals used to lessen the barriers and strengthen the facilitators?
Progress and Outcomes
Grant funding ending 9/1/2011.
Relevant Publications
- Ash JS, Sittig DF, McMullen CK, McCormack J, Wright A, Bunce A, Wasserman J, Mohan V, Cohen DJ, Shapiro M, Middleton B. Studying the Vendor Perspective on Clinical Decision Support. Submitted to American Medical Informatics Association Annual Symposium
- Radecki, RP, Sittig DF. Application of Electronic Health Records to the Joint Commission’s 2011 National Patient Safety Goals. JAMA 2011 306(1): 92-3.
- Ash JS, Sittig DF, Wright A, McMullen C, Shapiro M, Bunce A, Middleton B. Clinical decision support in small community practice settings: a case study. Journal of the American Medical Informatics Association. 2011 Apr 19.
- Sittig DF, Singh H. Legal, ethical, and financial dilemmas in electronic health record adoption and use. Pediatrics. 2011 Apr;127(4):e1042-7. Epub 2011 Mar 21. [Available on 2012/4/1] pubmed
- Richardson JE, Shah-Hosseini S, Fiadjoe JE, Ash JS, Rehman MA. The effects of a hands-free communication device system in a surgical suite. Journal of the American Medical Informatics Association 2011 Jan 1;18(1):70-2. Epub 2010 Nov 27. pubmed
- McMullen CK, Ash JS, Sittig DF, Bunce A, Guappone K, Dykstra R, Carpenter J, Richardson J, Wright A. Rapid assessment of clinical information system in the healthcare setting. An efficient method for time-pressed evaluation. Methods of Information in Medicine 2010 50(2). pubmed
Projects
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- Gulf Coast Regional Extension Center
- Improving the Safety and Quality of Pediatric Health Care
- Promoting Colorectal Cancer Screening Among Members of Internet Health Communities
- Optimizing Nutrition in Very Low Birth Weight Patients with Prolonged Transition to Full Enteral Feedings
- Clinical Decision Support in Community Hospitals: Barriers and Facilitators
- University of Texas System Patient Safety Activities
- AHRQ Training Program in Patient Safety and Quality: Using Health Information Technology to Improve Quality and Safety
- Using Electronic Data to Improve Care of Patients with Known or Suspected Cancer
- Using Electronic Records to Detect and Learn from Ambulatory Diagnostic Errors
- Crossing an Invisible Quality Chasm: From NICU To Ambulatory Care
- Prevention of Surgical Site Infections
- Developing a Composite Indicator to Measure the Quality of Neonatal Intensive Care
- Reducing Missed and Delayed Diagnoses in Cancer: Lessons from Aviation
- The Pebble Project
Safety Culture
