Factors Driving Resistance to Clinical Decision Support: Finding Inspiration in Radiology 3.0.
Purpose: The effectiveness of evidence-based guidelines (EBGs) and clinical decision support (CDS) is significantly hampered by widespread clinician resistance to it. Our study was designed to better understand the reasons for this resistance to CDS and explore the factors that drive it.Methods: We...
| Publicado en: | Journal of the American College of Radiology Vol. 19; no. 2; pp. 366 - 377 |
|---|---|
| Autores principales: | , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Feb2022:Part B
|
| 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=155190562&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155190562 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15461440 EAO jtl: Journal of the American College of Radiology issn: 15461440 maglogo: N pubinfo: dt: Feb2022:Part B vid: 19 iid: 2 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 155190562 155190562 NLM35152962 155190562 10.1016/j.jacr.2021.08.017 NLM35152962 155190562 ppf: 366 ppct: 11 formats: tig: atl: Factors Driving Resistance to Clinical Decision Support: Finding Inspiration in Radiology 3.0. aug: au: Bruno, Michael A. Fotos, Joseph S. Pitot, Marika Franceschi, Ana M. Neutze, Janet A. Willis, Mark H. Wasserman, Emily Snyder, Bethany L. Cruciata, Giuseppe Stuckey, Heather L. Wintermark, Max affil: Vice-Chair for Radiology Quality & Safety and Chief of Emergency Radiology, Department of Radiology, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine and Penn State Health, Hershey, Pennsylvania sug: subj: Specialties, Medical Decision Support Systems, Clinical Radiography Human ab: Purpose: The effectiveness of evidence-based guidelines (EBGs) and clinical decision support (CDS) is significantly hampered by widespread clinician resistance to it. Our study was designed to better understand the reasons for this resistance to CDS and explore the factors that drive it.Methods: We used a mixed-methods approach to explore and identify the drivers of resistance for CDS among clinicians, including a web-based multispecialty survey exploring clinicians' impressions of the strengths and weaknesses of CDS, two clinician focus groups, and several one-on-one focused clinician interviews in which individual participants were asked to comment on their rationale for choosing imaging utilization that might not be supported by EBGs. Additionally, a unique electronic learning and assessment module known as Amplifire was used to probe clinician knowledge gaps regarding EBGs and CDS.Results: In both the quantitative and qualitative portions of the study, the primary factor driving resistance to CDS was a desire to order studies not supported by EBGs, primarily for the purpose of reducing the clinician's diagnostic uncertainty.Conclusions: Our results suggest that to enhance the effectiveness of CDS, we must first address the issue of clinician discomfort with diagnostic uncertainty and the role of imaging via educational outreach and ongoing radiologist consultation. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|