SAGE Journals Online
Advertisement
Sign In to gain access to subscriptions and/or personal tools.

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Advertisement

Sign In to gain access to subscriptions and/or personal tools.
American Journal of Medical Quality
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Stevenson, K. B.
Right arrow Articles by Houck, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stevenson, K. B.
Right arrow Articles by Houck, P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Understanding Keys to Successful Implementation of Electronic Decision Support in Rural Hospitals: Analysis of a Pilot Study for Antimicrobial Prescribing

Kurt B. Stevenson, MD, MPH

The Ohio State University Medical Center, Columbus, Ohio, stevenson-9{at}medctr.osu.edu

James Barbera, RN

St Luke’s Regional Medical Center, Boise, Idaho

James W. Moore, MS

Qualis Health, Boise, Idaho

Matthew H. Samore, MD

VA Salt Lake City Health Care System and the Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City

Peter Houck, MD

Electronic clinical decision support systems (CDSS) have been hailed for their potential to improve clinical outcomes. Using a pretest/posttest design, an Internet-based CDSS designed to optimize antimicrobial prescribing was pilot tested for community-acquired pneumonia in 5 rural hospitals in southwestern Idaho. An antimicrobial management team was created in each hospital to address clinicians’ perception of excessive time required for direct use of the CDSS. In pooled hospital data, agreement with CDSS recommendations improved to a statistically significant level. However, inspection of data at the individual hospital level demonstrated that almost all improvement occurred in a single hospital. Failure in the other hospitals appeared to be primarily a consequence of organizational and cultural barriers. These barriers are discussed to understand keys for successful future implementation of CDSS in rural hospitals, drawing on experience with cultural barriers from other industries, specifically aviation.

Key Words: clinical decision support systems • performance improvement • quality improvement • rural hospitals • antimicrobial management • patient safety

American Journal of Medical Quality, Vol. 20, No. 6, 313-318 (2005)
DOI: 10.1177/1062860605281175
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?




Advertisement