Assessing the implementation of a clinical decision support tool in primary care for diabetes prevention: a qualitative interview study using the Consolidated Framework for Implementation Science.
Background: In this paper we describe the use of the Consolidated Framework for Implementation Research (CFIR) to study implementation of a web-based, point-of-care, EHR-linked clinical decision support (CDS) tool designed to identify and provide care recommendations for adults with prediabetes (Pre...
| Publicado en: | BMC Medical Informatics & Decision Making Vol. 22; no. 1; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
BioMed Central
1/15/2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=154705689&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 154705689 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14726947 1CI0 jtl: BMC Medical Informatics & Decision Making issn: 14726947 maglogo: N pubinfo: dt: 1/15/2022 vid: 22 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 154705689 154705689 NLM35033029 154705689 10.1186/s12911-021-01745-x NLM35033029 154705689 ppf: 1 ppct: 9 formats: tig: atl: Assessing the implementation of a clinical decision support tool in primary care for diabetes prevention: a qualitative interview study using the Consolidated Framework for Implementation Science. aug: au: Pratt, Rebekah Saman, Daniel M. Allen, Clayton Crabtree, Benjamin Ohnsorg, Kris Sperl-Hillen, JoAnn M. Harry, Melissa Henzler-Buckingham, Hilary O'Connor, Patrick J. Desai, Jay affil: Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware Street, 55414, Minneapolis, MN, USA sug: subj: Decision Support Systems, Clinical Diabetes Mellitus Prevention and Control Human Qualitative Studies Primary Health Care Adult Comparative Studies Multicenter Studies Randomized Controlled Trials Evaluation Research Validation Studies Scales Adult: 19-44 years ab: Background: In this paper we describe the use of the Consolidated Framework for Implementation Research (CFIR) to study implementation of a web-based, point-of-care, EHR-linked clinical decision support (CDS) tool designed to identify and provide care recommendations for adults with prediabetes (Pre-D CDS).Methods: As part of a large NIH-funded clinic-randomized trial, we identified a convenience sample of interview participants from 22 primary care clinics in Minnesota, North Dakota, and Wisconsin that were randomly allocated to receive or not receive a web-based EHR-integrated prediabetes CDS intervention. Participants included 11 clinicians, 6 rooming staff, and 7 nurse or clinic managers recruited by study staff to participate in telephone interviews conducted by an expert in qualitative methods. Interviews were recorded and transcribed, and data analysis was conducted using a constructivist version of grounded theory.Results: Implementing a prediabetes CDS tool into primary care clinics was useful and well received. The intervention was integrated with clinic workflows, supported primary care clinicians in clearly communicating prediabetes risk and management options with patients, and in identifying actionable care opportunities. The main barriers to CDS use were time and competing priorities. Finally, while the implementation process worked well, opportunities remain in engaging the care team more broadly in CDS use.Conclusions: The use of CDS tools for engaging patients and providers in care improvement opportunities for prediabetes is a promising and potentially effective strategy in primary care settings. A workflow that incorporates the whole care team in the use of such tools may optimize the implementation of CDS tools like these in primary care settings. Trial registration Name of the registry: Clinicaltrial.gov.Trial Registration Number: NCT02759055. Date of registration: 05/03/2016. URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT02759055 Prospectively registered. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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