Computerized clinical decision support: Defining end-user requirements for primary care staff and patients

Principal Investigator: Patricia C. Dykes, PhD, MA, RN

Authors: Hannah Rice, BA, Pamela N. Garabedian, MS, Kristen Shear, MAJ, AN, Zoe Burns, MPH, Ragnhildur Bjarnadottir, PhD, MPH, Nancy Latham, PhD, Robert Lucero, PhD, MPH, RN, Denise Schentrup, APRN, DNP, Patricia C. Dykes, PhD, MA, RN
Lay Abstract

A lot of older adults fall and hurt themselves. In primary care, there are not many tools that help older patients avoid falls. Our goal is to learn what staff need to keep their patients safe from falls and what patients need to avoid falls. We will use what we learn to build an electronic tool that gives staff recommendations on how to keep their patients safe from falls. We talked to staff and older patients at Brigham & Women’s primary care clinics and University of Florida Archer Family Health Care clinic. After talking to each person to figure out what their needs were, we grouped what we learned into themes. For example, we learned that staff need a tool that will not take a lot of time to use and helps them work together with other staff. Patients need support from friends or family and health care staff that they trust to teach them how to stay safe. What we learned from primary care staff and patients will be important as we build a tool to keep older adults safe from falls.

Scientific Abstract

Introduction: Our goal is to identify end-user (primary care staff and patients) requirements through a user-centered design (UCD) process for a tool that will generate computerized clinical decision support (CCDS) to protect older adults from falls.

 

Methods: Primary care staff and older patients at Brigham & Women’s (BWH) affiliated primary care clinics and University of Florida (UF) Archer Family Health Care clinic participated in semi-structured and exploratory interviews. End-user requirements for fall prevention CCDS were identified through content analysis.

 

Results: User requirement themes for staff included; 1) does not add significant time to office visits, 2) includes standardized resources to support recommendations, 3) helps staff work with patients to resolve ambivalence toward fall risk, 4) facilitates systematic communication between staff, 5) includes evidence-based recommendations, and 6) allows for in-person assessment of patient symptoms. Patient requirements included; 1) raise awareness of preventative strategies, 2) a need for personal support networks, 3) intrinsic and extrinsic motivation to engage with behavior change, and 4) provide expert guidance to successfully adhere to fall prevention practices.

 

Discussion/Conclusions: These findings suggest that there are many care gaps in fall prevention management in primary care and that personalized, actionable CCDS has the potential to address these gaps.

Clinical Implications
Learning what primary care staff and patients need to stay safe from falls will be an important part of building a tool that will help keep older adults safe.

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One reply on “Hannah Rice, BA”

The information was given in a clear and concise way. We were able to follow and understand. Thank you for your time and efforts to help providers and especially the patients.

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