Clinician Perspectives on Barriers and Enablers to Implementing an Inpatient Oncology Early Warning System: A Mixed-Methods Study.


Journal

JCO clinical cancer informatics
ISSN: 2473-4276
Titre abrégé: JCO Clin Cancer Inform
Pays: United States
ID NLM: 101708809

Informations de publication

Date de publication:
01 2023
Historique:
entrez: 27 1 2023
pubmed: 28 1 2023
medline: 1 2 2023
Statut: ppublish

Résumé

To elicit end-user and stakeholder perceptions regarding design and implementation of an inpatient clinical deterioration early warning system (EWS) for oncology patients to better fit routine clinical practices and enhance clinical impact. In an explanatory-sequential mixed-methods study, we evaluated a stakeholder-informed oncology early warning system (OncEWS) using surveys and semistructured interviews. Stakeholders were physicians, advanced practice providers (APPs), and nurses. For qualitative data, we used grounded theory and thematic content analysis via the constant comparative method to identify determinants of OncEWS implementation. Survey respondents generally agreed that an oncology-focused EWS could add value beyond clinical judgment, with nurses endorsing this notion significantly more strongly than other clinicians (nurse: median 5 on a 6-point scale [6 = strongly agree], interquartile range 4-5; doctors/advanced practice providers: 4 [4-5]; Stakeholders prioritized maximizing the degree to which the OncEWS is understandable, informative, actionable, and workflow-complementary, and perceived these factors to be key for translation into clinical benefit.

Identifiants

pubmed: 36706345
doi: 10.1200/CCI.22.00104
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e2200104

Subventions

Organisme : HSRD VA
ID : IK2 HX003005
Pays : United States

Auteurs

Patrick G Lyons (PG)

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, MO.
Healthcare Innovation Lab, BJC HealthCare, St Louis, MO.
Siteman Cancer Center, St Louis, MO.

Vanessa Chen (V)

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, MO.

Tejas C Sekhar (TC)

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, MO.

Colleen A McEvoy (CA)

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, MO.

Marin H Kollef (MH)

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University School of Medicine, St Louis, MO.

Ramaswamy Govindan (R)

Siteman Cancer Center, St Louis, MO.
Division of Hematology and Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO.

Peter Westervelt (P)

Siteman Cancer Center, St Louis, MO.
Division of Hematology and Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO.

Kelly C Vranas (KC)

Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR.
Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR.

Thomas M Maddox (TM)

Healthcare Innovation Lab, BJC HealthCare, St Louis, MO.
Division of Cardiology, Department of Medicine, Washington University School of Medicine, St Louis, MO.

Elvin H Geng (EH)

Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St Louis, MO.
Center for Dissemination and Implementation in the Institute for Public Health, Washington University School of Medicine, St Louis, MO.

Philip R O Payne (PRO)

Institute for Informatics, Washington University School of Medicine, St Louis, MO.

Mary C Politi (MC)

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO.
Center for Collaborative Care Decisions, Department of Surgery, Washington University School of Medicine, St Louis, MO.

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Classifications MeSH