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2018 ; 13
(1
): 86
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The GUIDES checklist: development of a tool to improve the successful use of
guideline-based computerised clinical decision support
#MMPMID29941007
Van de Velde S
; Kunnamo I
; Roshanov P
; Kortteisto T
; Aertgeerts B
; Vandvik PO
; Flottorp S
Implement Sci
2018[Jun]; 13
(1
): 86
PMID29941007
show ga
BACKGROUND: Computerised decision support (CDS) based on trustworthy clinical
guidelines is a key component of a learning healthcare system. Research shows
that the effectiveness of CDS is mixed. Multifaceted context, system,
recommendation and implementation factors may potentially affect the success of
CDS interventions. This paper describes the development of a checklist that is
intended to support professionals to implement CDS successfully. METHODS: We
developed the checklist through an iterative process that involved a systematic
review of evidence and frameworks, a synthesis of the success factors identified
in the review, feedback from an international expert panel that evaluated the
checklist in relation to a list of desirable framework attributes, consultations
with patients and healthcare consumers and pilot testing of the checklist.
RESULTS: We screened 5347 papers and selected 71 papers with relevant information
on success factors for guideline-based CDS. From the selected papers, we
developed a 16-factor checklist that is divided in four domains, i.e. the CDS
context, content, system and implementation domains. The panel of experts
evaluated the checklist positively as an instrument that could support people
implementing guideline-based CDS across a wide range of settings globally.
Patients and healthcare consumers identified guideline-based CDS as an important
quality improvement intervention and perceived the GUIDES checklist as a suitable
and useful strategy. CONCLUSIONS: The GUIDES checklist can support professionals
in considering the factors that affect the success of CDS interventions. It may
facilitate a deeper and more accurate understanding of the factors shaping CDS
effectiveness. Relying on a structured approach may prevent that important
factors are missed.