Clinical Decision Support Systems to Improve Utilization of Thromboprophylaxis: A Review of the Literature and Experience with Implementation of a Computerized Physician Order Entry Program

Adams, Paul C.; Riggio, Jeff M.; Thomson, Lynda; Brandell-Marino, Renee; Merli, Geno J.

doi:10.3810/hp.2012.08.987

Cited by 16 publications

(14 citation statements)

References 28 publications

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“…On the other hand, participants highlighted that the electronic medical record had facilitated the VTE practices through integrating the VTE risk assessment into the electronic medical records and admission process; this is similar to other studies and can provide support for clinicians by providing prompts and guiding practice through clinical support decision instructions for following the guidance (10,40,41). Moreover, computer alerts were associated in the literature with higher proportions of patients who received prophylaxis (38).…”

Section: Discussionmentioning

confidence: 60%

A Qualitative Study of Physicians’ Perceptions and Preferences for Implementing Venous Thromboembolism (VTE) Clinical Practice Guidelines Informed by the Theoretical Domains Framework (TDF)

Abboud

Rahman

Shaikh

et al. 2021

Preprint

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BackgroundThis study used the Theoretical Domains Framework to explore the beliefs and perceptions of physicians to influence the uptake of Venous Thromboembolism prevention guidelines.Methods Semi-structured interviews were conducted with a stratified purposive sample of internal medicine physicians in an acute hospital. The interview topic guide was developed using the Theoretical Domains Framework to identify the factors perceived to influence practice. Two researchers coded the interview transcripts using thematic content analysis. Emerging relevant themes were mapped to TDF domains.Results A total of sixteen medical physicians were interviewed over a six-month period. Nine theoretical domains derived from thirty-three belief statements were identified as relevant to the target behaviour; knowledge (education about the importance of VTE guidelines); beliefs about capabilities (with practice VTE tool easier to implement); beliefs about consequences ( positive consequences in reducing the development of VTE, length of stay, financial burden and support physician decision) and (negative consequence risk of bleeding); reinforcement (recognition and continuous reminders); goals (patient safety goal); environmental context and resources (workload and availability of medications were barriers, VTE coordinator and electronic medical record were enablers); social influences (senior physicians and patient/family influence the VTE practice); behavioural regulation (monitoring and mandatory hospital policy); and nature of the behaviour.Conclusions Using the Theoretical Domains Framework, factors thought to influence the implementation of VTE clinical practice guidelines in the internal medicine department were identified. These factors present theoretically based targets for future interventions.

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Section: Discussionmentioning

confidence: 60%

A Qualitative Study of Physicians’ Perceptions and Preferences for Implementing Venous Thromboembolism (VTE) Clinical Practice Guidelines Informed by the Theoretical Domains Framework (TDF)

Abboud

Rahman

Shaikh

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 60%

A qualitative study of physicians’ perceptions and preferences for implementing Venous Thromboembolism (VTE) clinical practice guidelines informed by the Theoretical Domains Framework (TDF)

Abboud

Rahman

Shaikh

et al. 2021

Preprint

View full text Add to dashboard Cite

Background This study used the Theoretical Domains Framework to explore the beliefs and perceptions of physicians to influence the uptake of Venous Thromboembolism prevention guidelines.Methods Semi-structured interviews were conducted with a stratified purposive sample of internal medicine physicians in an acute hospital. The interview topic guide was developed using the Theoretical Domains Framework to identify the factors perceived to influence practice. Two researchers coded the interview transcripts using thematic content analysis. Emerging relevant themes were mapped to TDF domains.Results A total of sixteen medical physicians were interviewed over a six-month period. Nine theoretical domains derived from thirty-three belief statements were identified as relevant to the target behaviour; knowledge (education about the importance of VTE guidelines); beliefs about capabilities (with practice VTE tool easier to implement); beliefs about consequences ( positive consequences in reducing the development of VTE, length of stay, financial burden and support physician decision) and (negative consequence risk of bleeding); reinforcement (recognition and continuous reminders); goals (patient safety goal); environmental context and resources (workload and availability of medications were barriers, VTE coordinator and electronic medical record were enablers); social influences (senior physicians and patient/family influence the VTE practice); behavioural regulation (monitoring and mandatory hospital policy); and nature of the behaviour.Conclusions Using the Theoretical Domains Framework, factors thought to influence the implementation of VTE clinical practice guidelines in the internal medicine department were identified. These factors present theoretically based targets for future interventions.

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“…Consistent with the published literature, the qualitative interviews highlighted that decision support strategy, including alerts, reminders, and computerised decision support, would facilitate the implementation of VTE prevention guidelines [ 8 , 38 , 39 ]. Nevertheless, the interviews noted that physicians might ignore alerts consistent with other published literature [ 40 ], which might contribute to alert fatigue [ 41 ].…”

Section: Discussionmentioning

confidence: 66%

Physicians’ perceptions and preferences for implementing venous thromboembolism (VTE) clinical practice guidelines: a qualitative study using the Theoretical Domains Framework (TDF)

et al. 2022

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Background Venous thromboembolism is a primary cause of morbidity and mortality in hospitalised patients. Clinical practice guidelines were developed to prevent venous thromboembolism events. This study adopted the Theoretical Domains Framework to explore the beliefs and perceptions of physicians adoption of clinical practice guidelines for the uptake of venous thromboembolism prevention guidelines. Methods Semi-structured interviews were conducted with a stratified purposive sample of internal medicine physicians in an acute hospital. The interview topic guide was developed using the Theoretical Domains Framework to identify the factors perceived to influence the practice. Two researchers coded the interview transcripts using thematic content analysis. Emerging relevant themes were mapped to TDF domains. Results A total of sixteen medical physicians were interviewed over a six-month period. Nine theoretical domains derived from thirty-three belief statements were identified as relevant to the target behaviour; knowledge (education about the importance of VTE guidelines); beliefs about capabilities (with practice VTE tool easier to implement); beliefs about consequences (positive consequences in reducing the development of VTE, length of stay, financial burden and support physician decision) and (negative consequence risk of bleeding); reinforcement (recognition and continuous reminders); goals (patient safety goal); environmental context and resources (workload and availability of medications were barriers, VTE coordinator and electronic medical record were enablers); social influences (senior physicians and patient/family influence the VTE practice); behavioural regulation (monitoring and mandatory hospital policy); and nature of the behaviour. Conclusions Using the Theoretical Domains Framework, factors thought to influence the implementation of VTE clinical practice guidelines were identified which can be used to design theoretically based interventions by targeting specific psychological constructs and linking them to behaviour change techniques to change the clinical practice of physicians.

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Clinical Decision Support Systems to Improve Utilization of Thromboprophylaxis: A Review of the Literature and Experience with Implementation of a Computerized Physician Order Entry Program

Cited by 16 publications

References 28 publications

A Qualitative Study of Physicians’ Perceptions and Preferences for Implementing Venous Thromboembolism (VTE) Clinical Practice Guidelines Informed by the Theoretical Domains Framework (TDF)

A Qualitative Study of Physicians’ Perceptions and Preferences for Implementing Venous Thromboembolism (VTE) Clinical Practice Guidelines Informed by the Theoretical Domains Framework (TDF)

A qualitative study of physicians’ perceptions and preferences for implementing Venous Thromboembolism (VTE) clinical practice guidelines informed by the Theoretical Domains Framework (TDF)

Physicians’ perceptions and preferences for implementing venous thromboembolism (VTE) clinical practice guidelines: a qualitative study using the Theoretical Domains Framework (TDF)

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