Clinical Decision Support for Fall Prevention: Defining End-User Needs.

Autor:	Rice H; Department of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Boston, Massachusetts, United States., Garabedian PM; Department of Information Systems, Mass General Brigham, Boston, Massachusetts, United States., Shear K; Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida, United States., Bjarnadottir RI; Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida, United States., Burns Z; Department of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Boston, Massachusetts, United States., Latham NK; Research Program in Men's Health: Aging and Metabolism, Brigham & Women's Hospital, Boston, Massachusetts, United States., Schentrup D; Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida, United States., Lucero RJ; Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida, United States.; School of Nursing, University of California, Los Angeles, Los Angeles, California, United States., Dykes PC; Department of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Boston, Massachusetts, United States.; Harvard Medical School, Boston, Massachusetts, United States.
Jazyk:	angličtina
Zdroj:	Applied clinical informatics [Appl Clin Inform] 2022 May; Vol. 13 (3), pp. 647-655. Date of Electronic Publication: 2022 Jun 29.
DOI:	10.1055/s-0042-1750360
Abstrakt:	Background and Significance: Falls in community-dwelling older adults are common, and there is a lack of clinical decision support (CDS) to provide health care providers with effective, individualized fall prevention recommendations. Objectives: The goal of this research is to identify end-user (primary care staff and patients) needs through a human-centered design process for a tool that will generate CDS to protect older adults from falls and injuries. Methods: Primary care staff (primary care providers, care coordinator nurses, licensed practical nurses, and medical assistants) and community-dwelling patients aged 60 years or older associated with Brigham & Women's Hospital-affiliated primary care clinics and the University of Florida Health Archer Family Health Care primary care clinic were eligible to participate in this study. Through semi-structured and exploratory interviews with participants, our team identified end-user needs through content analysis. Results: User needs for primary care staff ( n  = 24) and patients ( n  = 18) were categorized under the following themes: workload burden; systematic communication; in-person assessment of patient condition; personal support networks; motivational tools; patient understanding of fall risk; individualized resources; and evidence-based safe exercises and expert guidance. While some of these themes are specific to either primary care staff or patients, several address needs expressed by both groups of end-users. Conclusion: Our findings suggest that there are many care gaps in fall prevention management in primary care and that personalized, actionable, and evidence-based CDS has the potential to address some of these gaps. Competing Interests: None declared. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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