Decision-makers and mediators in a home healthcare digitisation process: nurses’ experiences of implementation and use of a decision support system

Nilsson, Lina; Fagerström, Cecilia

doi:10.1080/10376178.2018.1507676

Cited by 9 publications

(11 citation statements)

References 26 publications

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“…The 75 non-review, non-opinion articles used a variety of metrics to evaluate the usability and acceptability of their CDS tools, with many using more than one metric. The most common evaluation was via interviews (n=29) 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 , followed by surveys or questionnaires (n=16) 27 29 50 53 55 56 57 58 59 60 61 62 63 64 65 66 . Other qualitative feedback responses were obtained by focus groups or workshops (n=5) 43 57 61 67 68 .…”

Section: Resultsmentioning

confidence: 99%

Clinical Decision Support and Implications for the Clinician Burnout Crisis

Janković

Chen

2020

Yearb Med Inform

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Objectives: This survey aimed to review aspects of clinical decision support (CDS) that contribute to burnout and identify key themes for improving the acceptability of CDS to clinicians, with the goal of decreasing said burnout. Methods: We performed a survey of relevant articles from 2018-2019 addressing CDS and aspects of clinician burnout from PubMed and Web of Science™. Themes were manually extracted from publications that met inclusion criteria. Results: Eighty-nine articles met inclusion criteria, including 12 review articles. Review articles were either prescriptive, describing how CDS should work, or analytic, describing how current CDS tools are deployed. The non-review articles largely demonstrated poor relevance and acceptability of current tools, and few studies showed benefits in terms of efficiency or patient outcomes from implemented CDS. Encouragingly, multiple studies highlighted steps that succeeded in improving both acceptability and relevance of CDS. Conclusions: CDS can contribute to clinician frustration and burnout. Using the techniques of improving relevance, soliciting feedback, customization, measurement of outcomes and metrics, and iteration, the effects of CDS on burnout can be ameliorated.

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Section: Resultsmentioning

confidence: 99%

Clinical Decision Support and Implications for the Clinician Burnout Crisis

Janković

Chen

2020

Yearb Med Inform

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“…eHealth is defined as the use of information and communication technologies for health [8] and includes various forms of digital transmission of imaging and clinical data. Digital decision support systems (DDSSs) are a type of eHealth solution designed for clinical decisions and medical education [9] and for facilitating a multidisciplinary working environment and quality-assured guidance [10,11]. Few studies have focused on health care staff's engagement and barriers to and influencers of engagement during the introduction of eHealth interventions such as DDSSs, although the aspects of engagement are often described as crucial for the introduction and implementation [12,13] of new ways of working.…”

Section: Introductionmentioning

confidence: 99%

Health Care Staff’s Experiences of Engagement When Introducing a Digital Decision Support System for Wound Management: Qualitative Study

et al. 2020

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Background eHealth solutions such as digital decision support systems (DDSSs) have the potential to assist collaboration between health care staff to improve matters for specific patient groups. Patients with hard-to-heal ulcers have long healing times because of a lack of guidelines for structured diagnosis, treatment, and follow-up. Multidisciplinary collaboration in wound management teams is essential. A DDSS could offer a way of aiding improvement within wound management. The introduction of eHealth solutions into health care is complicated, and the engagement of the staff seems crucial. Factors influencing and affecting engagement need to be understood and considered for the introduction of a DDSS to succeed. Objective This study aims to describe health care staff’s experiences of engagement and barriers to and influencers of engagement when introducing a DDSS for wound management. Methods This study uses a qualitative approach. Interviews were conducted with 11 health care staff within primary (n=4), community (n=6), and specialist (n=1) care during the start-up of the introduction of a DDSS for wound management. The interviews focused on the staff’s experiences of engagement. Content analysis by Burnard was used in the data analysis process. Results A total of 4 categories emerged describing the participants’ experiences of engagement: a personal liaison, a professional commitment, an extended togetherness, and an awareness and understanding of the circumstances. Conclusions This study identifies barriers to and influencers of engagement, reinforcing that staff experience engagement through feeling a personal liaison and a professional commitment to make things better for their patients. In addition, engagement is nourished by sharing with coworkers and by active support and understanding from leadership.

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“…We classified the selected studies in five groups, according to the main purpose of ICT use by health care aides: (1) improve everyday work (n ¼ 12, 30%), 46,[51][52][53][54][55][56][57][58][59][60][61] (2) access electronic health records for home care (n ¼ 9, 22.5%), [62][63][64][65][66][67][68][69][70] (3) facilitate client assessment and care planning (n ¼ 9, 22.5%), [71][72][73][74][75][76][77][78][79] (4) enhance communication (n ¼ 7, 17.5%), 2,40,80-83 and (5) provide care remotely (n ¼ 3, 7.5%). 35,84,85 Fig.…”

Section: Study Purposementioning

confidence: 99%

“…35,46,65,70,72 In addition to usability issues, 59 we found connectivity issues, as a significant hardware barrier in this group. 56,64,71,84 Some studies reported incomplete hardware features as a significant barrier to adopting and implementing ICT. 56,65,77,86 Time-consuming adoption and implementation was another significant barrier for health care aides, 2,35,40,51,53,55,56,59,[63][64][65]85 This further amplifies the need for communication with ICT providers in order for an effective ICT solution.…”

Section: Barriersmentioning

confidence: 99%

“…56,64,71,84 Some studies reported incomplete hardware features as a significant barrier to adopting and implementing ICT. 56,65,77,86 Time-consuming adoption and implementation was another significant barrier for health care aides, 2,35,40,51,53,55,56,59,[63][64][65]85 This further amplifies the need for communication with ICT providers in order for an effective ICT solution. 71,72,76 In some studies, users reported the ICT implementation process as time consuming.…”

Section: Barriersmentioning

confidence: 99%

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Barriers and Benefits of Information Communication Technologies Used by Health Care Aides

et al. 2022

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Background Although information and communication technologies (ICT) are becoming more common among health care providers, there is little evidence on how ICT can support health care aides. Health care aides, also known as personal care workers, are unlicensed service providers who encompass the second largest workforce, next to nurses, that provide care to older adults in Canada. Objective The purpose of this literature review is to examine the range and extent of barriers and benefits of ICT used by health care workers to manage and coordinate the care-delivery workflow for their clients. Methods We conducted a literature review to examine the range and extent of ICT used by health care aides to manage and coordinate their care delivery, workflow, and activities. We identified 8,958 studies of which 40 were included for descriptive analyses. Results We distinguished the following five different purposes for the use and implementation of ICT by health care aides: (1) improve everyday work, (2) access electronic health records for home care, (3) facilitate client assessment and care planning, (4) enhance communication, and (5) provide care remotely. We identified 128 barriers and 130 benefits related to adopting ICT. Most of the barriers referred to incomplete hardware and software features, time-consuming ICT adoption, heavy or increased workloads, perceived lack of usefulness of ICT, cost or budget restrictions, security and privacy concerns, and lack of integration with technologies. The benefits for health care aides' adoption of ICT were improvements in communication, support to workflows and processes, improvements in resource planning and health care aides' services, and improvements in access to information and documentation. Conclusion Health care aides are an essential part of the health care system. They provide one-on-one care to their clients in everyday tasks. Despite the scarce information related to health care aides, we identified many benefits of ICT adoption.

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Decision-makers and mediators in a home healthcare digitisation process: nurses’ experiences of implementation and use of a decision support system

Cited by 9 publications

References 26 publications

Clinical Decision Support and Implications for the Clinician Burnout Crisis

Clinical Decision Support and Implications for the Clinician Burnout Crisis

Health Care Staff’s Experiences of Engagement When Introducing a Digital Decision Support System for Wound Management: Qualitative Study

Barriers and Benefits of Information Communication Technologies Used by Health Care Aides

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