Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder

Abstract Objective: Computerized clinical decision support (CDS) assists healthcare professionals in making decisions to improve patient care. In the realms of antimicrobial stewardship (ASP) and infection prevention (IP) programs, CDS interventions can play a crucial role in optimizing antibiotic...

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Main Authors: Mary Rochelle Smith, Julie J. Lee, Marisa Holubar, Jorge L. Salinas, Mindy M. Sampson, Richard J. Medford, Amy Chang
Format: Article
Language:English
Published: Cambridge University Press 2024-01-01
Series:Antimicrobial Stewardship & Healthcare Epidemiology
Online Access:https://www.cambridge.org/core/product/identifier/S2732494X24004480/type/journal_article
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author Mary Rochelle Smith
Julie J. Lee
Marisa Holubar
Jorge L. Salinas
Mindy M. Sampson
Richard J. Medford
Amy Chang
author_facet Mary Rochelle Smith
Julie J. Lee
Marisa Holubar
Jorge L. Salinas
Mindy M. Sampson
Richard J. Medford
Amy Chang
author_sort Mary Rochelle Smith
collection DOAJ
description Abstract Objective: Computerized clinical decision support (CDS) assists healthcare professionals in making decisions to improve patient care. In the realms of antimicrobial stewardship (ASP) and infection prevention (IP) programs, CDS interventions can play a crucial role in optimizing antibiotic prescribing practices, reducing healthcare-associated infections, and promoting diagnostic stewardship when optimally designed. This primer article aims to provide ASP and IP professionals with a practical framework for the development, design, and evaluation of CDS interventions. Setting: Large academic medical center design: Established frameworks of CDS evaluation, “Five Rights” of CDS and the “Ten Commandments of Effective Clinical Decision Support”, were applied to two real-world examples of CDS tools, a Vancomycin Best Practice Advisory and a Clostridioides Difficile order panel, to demonstrate a structured approach to developing and enhancing the functionality of ASP/IP CDS interventions to promote efficacy and reduce unintended consequences of CDS. Conclusions: By outlining a structured approach for the development and evaluation of CDS interventions, with focus on end user engagement, efficiency and feasibility, ASP and IP professionals can leverage CDS to enhance IP/ASP quality improvement initiatives aimed to improve antibiotic utilization, diagnostic stewardship, and adherence to IP protocols.
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publisher Cambridge University Press
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series Antimicrobial Stewardship & Healthcare Epidemiology
spelling doaj-art-10954710f7a646b8b83ef3fbd70ad3a72025-08-20T02:14:59ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2024-01-01410.1017/ash.2024.448Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harderMary Rochelle Smith0https://orcid.org/0009-0006-4833-2217Julie J. Lee1https://orcid.org/0009-0002-6640-8597Marisa Holubar2https://orcid.org/0000-0002-7585-1809Jorge L. Salinas3Mindy M. Sampson4Richard J. Medford5https://orcid.org/0000-0001-9814-8043Amy Chang6https://orcid.org/0000-0002-1194-8222Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, CA, USADivision of Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA, USADivision of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, CA, USADivision of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, CA, USADivision of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, CA, USADivision of Infectious Diseases & Geographic Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USADivision of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Palo Alto, CA, USA Abstract Objective: Computerized clinical decision support (CDS) assists healthcare professionals in making decisions to improve patient care. In the realms of antimicrobial stewardship (ASP) and infection prevention (IP) programs, CDS interventions can play a crucial role in optimizing antibiotic prescribing practices, reducing healthcare-associated infections, and promoting diagnostic stewardship when optimally designed. This primer article aims to provide ASP and IP professionals with a practical framework for the development, design, and evaluation of CDS interventions. Setting: Large academic medical center design: Established frameworks of CDS evaluation, “Five Rights” of CDS and the “Ten Commandments of Effective Clinical Decision Support”, were applied to two real-world examples of CDS tools, a Vancomycin Best Practice Advisory and a Clostridioides Difficile order panel, to demonstrate a structured approach to developing and enhancing the functionality of ASP/IP CDS interventions to promote efficacy and reduce unintended consequences of CDS. Conclusions: By outlining a structured approach for the development and evaluation of CDS interventions, with focus on end user engagement, efficiency and feasibility, ASP and IP professionals can leverage CDS to enhance IP/ASP quality improvement initiatives aimed to improve antibiotic utilization, diagnostic stewardship, and adherence to IP protocols. https://www.cambridge.org/core/product/identifier/S2732494X24004480/type/journal_article
spellingShingle Mary Rochelle Smith
Julie J. Lee
Marisa Holubar
Jorge L. Salinas
Mindy M. Sampson
Richard J. Medford
Amy Chang
Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder
Antimicrobial Stewardship & Healthcare Epidemiology
title Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder
title_full Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder
title_fullStr Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder
title_full_unstemmed Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder
title_short Clinical decision support in the electronic health record: a primer for antimicrobial stewards and infection preventionists: work smarter so end users don’t work harder
title_sort clinical decision support in the electronic health record a primer for antimicrobial stewards and infection preventionists work smarter so end users don t work harder
url https://www.cambridge.org/core/product/identifier/S2732494X24004480/type/journal_article
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