Sleep MAPP: a decision support tool for guideline-concordant sleep care in the polytrauma/traumatic brain injury system of care.

Abstract

Objective: First, to summarize the development of Sleep MAPP, a decision support tool designed to facilitate guideline-concordant sleep disorder care in the Veterans Health Administration (VHA) Polytrauma/Traumatic Brain Injury System of Care (PSC). Second, to assess usability, acceptability, and feasibility.

Methods: We iteratively designed Sleep MAPP, including algorithms determining eligibility for guideline-concordant care using medical record data. A convergent parallel mixed-methods design elicited prototype feedback from VHA clinicians (n = 7). Qualitative themes were derived from semi-structured interviews and quantitative data were obtained from standardized assessments of usability, acceptability, and feasibility. A joint display was used to derive conclusions.

Results: Clinicians found Sleep MAPP easy-to-use, highlighting its intuitive functionality, but suggested increased customizability. Sleep MAPP was seen as acceptable, facilitating time-efficient sleep care while improving clinical outcomes. Changes to algorithm specifications were recommended. Sleep MAPP was considered feasible due to alignment with PSC clinical workflows. Educational meetings and developing an implementation plan were recommended to enhance implementation.

Conclusions: Sleep MAPP was considered usable, acceptable, and feasible to implement. Feedback will guide revisions to the tool and development of an implementation blueprint to integrate Sleep MAPP into routine PSC services, enhancing sleep care and rehabilitation outcomes among Veterans with TBI.