Clinical Decision Support Systems (CDSSs)

Clinical Decision Support Systems (CDSSs)

“Clinical decision support systems (CDSSs) are active knowledge systems that use two or more items of patient data to generate case-specific advice” (Kotze & Brdaroska, 2004, pg. 361). CDSs have the ability to improve patient care and put in place safety stops that can help prevent errors. They are meant to provide additional diagnostic information to clinicians to better improve the care that they give to their patients. One clinical decision support tool that I have seen in practice are red flags notifying critical lab results. This helps to make the lab result more easily identifiable and alerts the nurse and provider that something is off. In our old EHR system, Meditech, we (nurses) would receive medication specific alerts. For example, upon scanning a Lithium medication barcode, a patients lithium values would pop up if they were out of range. I found this to be helpful, as we could closely monitor the patients values and discuss with the doctor if symptoms we were seeing in a patient were indicative of a need to adjust medication. Another notification that we would receive is whether or not a patient had an allergy listed that coincided with a medication to be administered. However, in our new EHR, EPIC, we do not receive these notifications. This is something that I have brought up to the care team. If I could create my own clinical decision support tool, thinking specifically about the hospital that I work at and the EHR that we are currently using, I would create a better admission flowsheet. The way that the admission process currently is, there is a lot of jumping back and forth between pages and there is a greater opportunity for missed information. Another possible clinical decision support tool relates to our use of care plans. When developing a care plan for a patient, we have a database to search that includes a variety of diagnoses and appropriate interventions. However, I have found that the database is quite limited in terms of psychiatric diagnoses. Kotze, B., & Brdaroska, B. (2004). Clinical psychiatry: clinical decision support systems in psychiatry in the information age. Australasian Psychiatry, 12(4), 361–364.