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Information technology for clinical guideline implementation: perceptions of multidisciplinary stakeholders
Journal article   Open access

Information technology for clinical guideline implementation: perceptions of multidisciplinary stakeholders

Stacie Salsbury Lyons, Toni Tripp-Reimer, Bernard A Sorofman, Jane E Dewitt, Bonnie J Bootsmiller, Thomas E Vaughn and Bradley N Doebbeling
Journal of the American Medical Informatics Association : JAMIA, Vol.12(1), pp.64-71
01/2005
DOI: 10.1197/jamia.M1495
PMCID: PMC543828
PMID: 15492035
url
https://doi.org/10.1197/jamia.M1495View
Published (Version of record) Open Access

Abstract

This multisite study compared the perceptions of three stakeholder groups regarding information technologies as barriers to and facilitators of clinical practice guidelines (CPGs). The study settings were 18 U.S. Veterans Affairs Medical Centers. A purposive sample of 322 individuals participated in 50 focus groups segmented by profession and included administrators, physicians, and nurses. Focus group participants were selected based on their knowledge of practice guidelines and involvement in facility-wide guideline implementation. Descriptive content analysis of 1,500 pages of focus group transcripts. Eighteen themes clustered into four domains. Stakeholders were similar in discussing themes in the computer function domain most frequently but divergent in other domains, with workplace factors more often discussed by administrators, system design issues discussed most by nurses, and personal concerns discussed by physicians and nurses. Physicians and nurses most often discussed barriers, whereas administrators focused most often on facilitation. Facilitators included guideline maintenance and charting formats. Barriers included resources, attitudes, time and workload, computer glitches, computer complaints, data retrieval, and order entry. Themes with dual designations included documentation, patient records, decision support, performance evaluation, CPG implementation, computer literacy, essential data, and computer accessibility. Stakeholders share many concerns regarding the relationships between information technologies and clinical guideline use. However, administrators, physicians, and nurses hold different opinions about specific facilitators and barriers. Health professionals' disparate perceptions could undermine guideline initiatives. Implementation plans should specifically incorporate actions to address these barriers and enhance the facilitative aspects of information technologies in clinical practice guideline use.
 United States Attitude of Health Personnel Physicians Humans Middle Aged Focus Groups Information Systems Male Hospital Administrators Guideline Adherence Nurses Attitude to Computers Adult Female Hospitals, Veterans Practice Guidelines as Topic

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