医院抗菌药物管理团队对计算机化临床决策支持系统的看法和可用性

IF 3.7 2区医学 Q2 COMPUTER SCIENCE, INFORMATION SYSTEMS

International Journal of Medical Informatics Pub Date : 2024-10-12 DOI:10.1016/j.ijmedinf.2024.105653

Alexandre Baudet , Marie-Jo Brennstuhl , Alexandre Charmillon , Florence Meyer , Céline Pulcini , Nathalie Thilly , Béatrice Demoré , Arnaud Florentin

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引用次数: 0

摘要

背景抗菌药物监管（AMS）计划旨在通过一系列干预措施优化抗生素的使用。计算机化临床决策支持系统（CDSS）的实施为抗菌药物管理团队进行半自动抗菌药物审查提供了新的机遇。本研究旨在评估最终用户对最近在一家医院实施的商用 CDSS 所感受到的促进因素、障碍和益处，并评估其可用性。方法：在法国东北部的一家大学医院实施 CDSS 九个月后，对 AMS 团队成员采用了混合方法。在个人半结构化访谈的基础上进行了定性分析，以收集最终用户的看法。采用系统可用性量表（SUS）进行了定量分析。定性分析揭示了 CDSS 实施过程中存在的技术、组织和人力方面的障碍和促进因素。与信息技术团队的有效合作对于确保软件的安装和配置至关重要。医疗服务团队采用 CDSS 需要时间、人力资源、培训、调整和临床领导。此外，CDSS 必须设计精良、便于使用，并能为 AMS 的活动带来益处。定量分析结果表明，就易用性而言，CDSS 是一个 "好 "系统（SUS 评分中位数：77.5/100）。它揭示了实施和采用 CDSS 的障碍、促进因素和益处。这些障碍和促进因素可供其他医院在实施该软件时参考。

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Hospital antimicrobial stewardship team perceptions and usability of a computerized clinical decision support system

Background

Antimicrobial stewardship (AMS) programs aim to optimize antibiotic use through a panel of interventions. The implementation of computerized clinical decision support systems (CDSSs) offers new opportunities for semiautomated antimicrobial review by AMS teams. This study aimed to evaluate the perceived facilitators, barriers and benefits of end-users related to a commercial CDSS recently implemented in a hospital and to assess its usability.

Methods

A mixed-method approach was used among AMS team members nine months after the implementation of the CDSS in a university hospital in northeastern France. A qualitative analysis based on individual semistructured interviews was conducted to collect end-users’ perceptions. A quantitative analysis was performed using the System Usability Scale (SUS).

Results

Eleven AMS team members agreed to participate. The qualitative analysis revealed technical, organizational and human barriers and facilitators of CDSS implementation. Effective collaboration with information technology teams was crucial for ensuring the installation and configuration of the software. CDSS adoption by the AMS team required time, human resources, training, adaptation and a clinical leader. Moreover, the CDSS had to be well designed, user-friendly and provide benefits to AMS activities. The quantitative analysis indicated that the CDSS was a “good” system in terms of perceived ease of use (median SUS score: 77.5/100).

Conclusions

This study shows the value of the studied CDSS to support AMS activities. It reveals barriers, facilitators and benefits to the implementation and adoption of the CDSS. These barriers and facilitators could be considered to facilitate the implementation of the software in other hospitals.

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来源期刊

International Journal of Medical Informatics 医学-计算机：信息系统

CiteScore

8.90

自引率

4.10%

发文量

217

审稿时长

42 days

期刊介绍： International Journal of Medical Informatics provides an international medium for dissemination of original results and interpretative reviews concerning the field of medical informatics. The Journal emphasizes the evaluation of systems in healthcare settings. The scope of journal covers: Information systems, including national or international registration systems, hospital information systems, departmental and/or physician''s office systems, document handling systems, electronic medical record systems, standardization, systems integration etc.; Computer-aided medical decision support systems using heuristic, algorithmic and/or statistical methods as exemplified in decision theory, protocol development, artificial intelligence, etc. Educational computer based programs pertaining to medical informatics or medicine in general; Organizational, economic, social, clinical impact, ethical and cost-benefit aspects of IT applications in health care.