Collective agency in the implementation of computerized clinical decision support: an interpretive description study.

Introduction: Digital health interventions, such as computerized clinical decision support systems (CDSSs), often falter due to resource constraints, misaligned workflows, and limited engagement from key users and stakeholders. Little is known about how research-to-practice professionals navigate th...

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Publicado en:JBI Evidence Implementation Vol. 24; no. 3; pp. 574 - 590
Autores principales: Fernando, Manasha, Naicker, Sundresan, Abell, Bridget, McPhail, Steven M., Tyack, Zephanie
Formato: research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Jul2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2026
      vid: 24
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        10.1097/XEB.0000000000000561
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        atl: Collective agency in the implementation of computerized clinical decision support: an interpretive description study.
      aug:
        au:
          Fernando, Manasha
          Naicker, Sundresan
          Abell, Bridget
          McPhail, Steven M.
          Tyack, Zephanie
        affil: Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia
      sug:
        subj:
          Decision Support Systems, Clinical Utilization
          Systems Implementation
          Attitude of Health Personnel Evaluation
          Health Services Research
          Health Informatics
          Implementation Science
          Digital Health
          Human
          Descriptive Research
          Funding Source
          Australia
          United Kingdom
          United States
          New Zealand
          Canada
          Convenience Sample
          Purposive Sample
          Snowball Sample
          Male
          Female
          Stakeholder Participation
          Semi-Structured Interview
          Focus Groups
          Constant Comparative Method
          Collaboration
          Male
          Female
      ab: Introduction: Digital health interventions, such as computerized clinical decision support systems (CDSSs), often falter due to resource constraints, misaligned workflows, and limited engagement from key users and stakeholders. Little is known about how research-to-practice professionals navigate these challenges. Aim: This study sought to understand how CDSSs can be integrated into routine clinical practice and the contextual factors that influence translation. Methods: Using interpretive description methodology, we conducted semi-structured interviews with 32 participants and three focus groups involving 11 participants to explore perspectives and experiences of translating implementation knowledge into practice. Participants included experts in health services research, implementation science, and health informatics. Convenience, purposive, and snowball sampling were used to recruit participants. Results: The findings describe how CDSS implementation is a socially driven process. Success was framed in terms of harnessing collective agency—building trust, fostering collaboration, and empowering people to work toward shared understanding. This process involved (1) laying the groundwork by engaging those affected; (2) making implementation accessible by adapting theories into usable tools; and (3) breaking slow progress by learning from past efforts and strengthening clinical–academic partnerships. Conclusions: The findings highlight opportunities for developing accessible tools and partnerships and embedding experiential knowledge. Practice recommendations are offered to support CDSS implementation teams, including setting up regular feedback channels, using memoranda of understanding, and checklists for implementation. http://links.lww.com/IJEBH/A501
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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