Introduction
The author’s current practice setting is an inpatient mental healthcare facility that serves adult and geriatric patients and administers pharmaceutical treatment and non-pharmacological interventions, including cognitive-behavioral therapy. One initiative that the facility could benefit from is adopting a comprehensive clinical decision support system (CDSS) and integrating it into the facility’s EMR system. This paper discusses the hypothetical initiative with reference to barriers and strategies/resources that would support a smooth transition to new working practices.
Rationale for Initiative Selection
The rationale for the initiative relates to CDSS solutions’ ability to promote better patient outcomes. Although treatment mistakes in the aforementioned facility are uncommon, a CDSS would improve psychiatrists’ ability to match patient characteristics with the most recent treatment guidelines and research data and reduce the detrimental impacts of the human factor and exhaustion on decisions’ feasibility and drug interaction analysis (Koposov et al., 2017). Increases in the aging workforce affect the practice setting and add to the risks of clinicians’ failure to account for new evidence in decision-making, and a CDSS would reduce these threats to the minimal level.
Potential Barriers to Implementation
Financial constraints, lack of experience in CDSS utilization, and the clinical staff’s resistance to innovation can be the barriers to proceeding with the proposal. Computerized CDSS solutions may incur considerable installation costs at the implementation stage, and clinicians’ inexperience in using such databases would also involve the need for specialized training programs and initiatives to keep track of the application’s utilization (Liberati et al., 2017). Some professionals’ pre-retirement age might be another contributor to the lack of sound IT and database search skills, thus adding to the intention to resist innovation. End-users’ resistance might also stem from the fear of making disputable treatment decisions because of data entry mistakes and incorrect search queries (Liberati et al., 2017). Therefore, there are multiple barriers to be addressed for smooth change implementation.
Change Management Strategies and Key Resources
Change management strategies would be helpful in facilitating implementation and selecting the resources to overcome barriers to improvement. Particularly, the five-step ADKAR model (awareness, desire, knowledge, ability, and reinforcement) would be applied to pave the way for positive change (Wong et al., 2019). Following the listed steps, it would be crucial to use credible data sources to promote the awareness of CDSS applications’ financial feasibility and positive influences on decision accuracy and evidence-based practice implementation. The next steps would emphasize building the desire to change by organizing CDSS software demonstrations and ensuring the presence of knowledge regarding change by means of lectures for the staff focused on the clinical opportunities of CDSS. Finally, the facility’s ability to implement change would be maximized by establishing the interprofessional teaching team and reinforcing CDSS adoption by offering ongoing technical and clinical support to end-users. With that in mind, the resources for addressing barriers would include the facility’s IT lead, the vendor’s support services, and training materials.
Leadership Strategies
In the discussed case, there would be the need for strategies to advance positive attitudes toward CDSS tools and relevant beliefs among the clinical staff. Using the TIGER competency BBN09 that deals with the identification of key stakeholders and their roles during different stages of IT projects, it would be essential to develop a thorough staff teaching and support plan to prevent nurses’ and psychiatrists’ resistance to CDSS (Shaw et al., 2017). Most importantly, the plan would focus on attitude change through the demonstration of CDSS-related advantages, ranging from the minimization of drug-drug interaction errors to reminders to eliminate delayed dose mistakes. Therefore, making leadership strategies revolve around the maximization of the workforce’s awareness of IT innovations’ benefits is a viable choice.
Conclusion
Finally, CDSS adoption at psychiatric facilities might be fraught with diverse barriers dealing with staff members’ attitudes to technology and doubts regarding such solutions’ cost-effectiveness. Multi-step change management strategies and pre-implementation staff education initiatives can reduce these barriers and promote changes in culture. With adequate human and information resources and IT proficiency, these strategies have significant prospects for success.
References
Koposov, R., Fossum, S., Frodl, T., Nytro, O., Leventhal, B., Sourander, A., Ouaglini, S., Molteni, M., Vaya, M. I., Prokosch, H. U., Barbarini, N., Milham, M. P., Castellanos, F. X., & Skokauskas, N. (2017). Clinical decision support systems in child and adolescent psychiatry: A systematic review. European Child & Adolescent Psychiatry, 26(11), 1309-1317.
Liberati, E. G., Ruggiero, F., Galuppo, L., Gorli, M., González-Lorenzo, M., Maraldi, M., Ruggieri, P., Friz, H. P., Scaratti, G., Kwag, K. H., Vespignani, R., & Moja, L. (2017). What hinders the uptake of computerized decision support systems in hospitals? A qualitative study and framework for implementation. Implementation Science, 12(1), 1-13.
Shaw, T., Blake, R., HĂĽbner, U., Anderson, C., Wangia-Anderson, V., & Elias, B. (2017). The evolution of TIGER competencies and informatics resources: Executive supplemental report. Healthcare Information and Management Systems Society, Inc. Web.
Wong, Q., Lacombe, M., Keller, R., Joyce, T., & O’Malley, K. (2019). Leading change with ADKAR. Nursing Management, 50(4), 28-35.