Appl Clin Inform 2016; 07(02): 227-237
DOI: 10.4338/ACI-2015-10-RA-0128
Research Article
Schattauer GmbH

Analysis of Nursing Clinical Decision Support Requests and Strategic Plan in a Large Academic Health System

Kimberly Whalen
1  Massachusetts General Hospital, Boston, MA
5  University of Colorado Denver, Denver, CO
,
Karen Bavuso
2  Partners Healthcare System, Wellesley, MA
,
Sharon Bouyer-Ferullo
2  Partners Healthcare System, Wellesley, MA
,
Denise Goldsmith
3  Brigham and Women’s Hospital, Boston, MA
,
Amanda Fairbanks
2  Partners Healthcare System, Wellesley, MA
,
Emily Gesner
2  Partners Healthcare System, Wellesley, MA
,
Charles Lagor
2  Partners Healthcare System, Wellesley, MA
,
Sarah Collins
2  Partners Healthcare System, Wellesley, MA
3  Brigham and Women’s Hospital, Boston, MA
4  Harvard Medical School, Boston, MA
› Author Affiliations
Further Information

Correspondence to:

Kimberly Whalen MSN, RN
Massachusetts General Hospital
Boston
MA 02114

Publication History

received: 07 October 2015

accepted: 01 February 2016

Publication Date:
16 December 2017 (online)

 

Summary

Objectives

To understand requests for nursing Clinical Decision Support (CDS) interventions at a large integrated health system undergoing vendor-based EHR implementation. In addition, to establish a process to guide both short-term implementation and long-term strategic goals to meet nursing CDS needs.

Materials and Methods

We conducted an environmental scan to understand current state of nursing CDS over three months. The environmental scan consisted of a literature review and an analysis of CDS requests received from across our health system. We identified existing high priority CDS and paper-based tools used in nursing practice at our health system that guide decision-making.

Results

A total of 46 nursing CDS requests were received. Fifty-six percent (n=26) were specific to a clinical specialty; 22 percent (n=10) were focused on facilitating clinical consults in the inpatient setting. “Risk Assessments/Risk Reduction/Promotion of Healthy Habits” (n=23) was the most requested High Priority Category received for nursing CDS. A continuum of types of nursing CDS needs emerged using the Data-Information-Knowledge-Wisdom Conceptual Framework: 1) facilitating data capture, 2) meeting information needs, 3) guiding knowledge-based decision making, and 4) exposing analytics for wisdom-based clinical interpretation by the nurse.

Conclusion

Identifying and prioritizing paper-based tools that can be modified into electronic CDS is a challenge. CDS strategy is an evolving process that relies on close collaboration and engagement with clinical sites for short-term implementation and should be incorporated into a long-term strategic plan that can be optimized and achieved overtime. The Data-Information-Knowledge-Wisdom Conceptual Framework in conjunction with the High Priority Categories established may be a useful tool to guide a strategic approach for meeting short-term nursing CDS needs and aligning with the organizational strategic plan.


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Conflict of interest

None of the listed authors have any financial or personal relationships with other people or organizations that may inappropriately influence of bias the objectivity of submitted content and /or its acceptance of publication in this journal.


Correspondence to:

Kimberly Whalen MSN, RN
Massachusetts General Hospital
Boston
MA 02114