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Clinical decision support system (CDSS) – effects on care quality

Marco António Ferreira Rodrigues Nogueira dos Santos (Division of Quality Sciences/Centre for Healthcare Improvement, Chalmers University of Technology, Gothenburg, Sweden)
Hans Tygesen (Department of Cardiology, Södra Älvsborg Hospital, Borås, Sweden)
Henrik Eriksson (Division of Quality Sciences/Centre for Healthcare Improvement, Chalmers University of Technology, Gothenburg, Sweden)
Johan Herlitz (Centre of Pre-Hospital Research in Western Sweden, University of Borås and Sahlgrenska University Hospital, Gothenburg, Sweden)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 7 October 2014

1685

Abstract

Purpose

Despite their efficacy, some recommended therapies are underused. The purpose of this paper is to describe clinical decision support system (CDSS) development and its impact on clinical guideline adherence.

Design/methodology/approach

A new CDSS was developed and introduced in a cardiac intensive care unit (CICU) in 2003, which provided physicians with patient-tailored reminders and permitted data export from electronic patient records into a national quality registry. To evaluate CDSS effects in the CICU, process indicators were compared to a control group using registry data. All CICUs were in the same region and only patients with acute coronary syndrome were included.

Findings

CDSS introduction was associated with increases in guideline adherence, which ranged from 16 to 35 per cent, depending on the therapy. Statistically significant associations between guideline adherence and CDSS use remained over the five-year period after its introduction. During the same period, no relapses occurred in the intervention CICU.

Practical implications

Guideline adherence and healthcare quality can be enhanced using CDSS. This study suggests that practitioners should turn to CDSS to improve healthcare quality.

Originality/value

This paper describes and evaluates an intervention that successfully increased guideline adherence, which improved healthcare quality when the intervention CICU was compared to the control group.

Keywords

Acknowledgements

The authors thank Associate Professor Ulla Blomqvist for her statistical assistance, Adjunct Professor Bengt-Arne Sjöqvist, Annica-Ravn Fischer, Bo Hallin and Susanne Gustavsson for their insights and comments.

Citation

António Ferreira Rodrigues Nogueira dos Santos, M., Tygesen, H., Eriksson, H. and Herlitz, J. (2014), "Clinical decision support system (CDSS) – effects on care quality", International Journal of Health Care Quality Assurance, Vol. 27 No. 8, pp. 707-718. https://doi.org/10.1108/IJHCQA-01-2014-0010

Publisher

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Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited

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