Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Views and uses of sepsis digital alerts in National Health Service Trusts in England: Qualitative study with health care professionals

Lazzarino, Runa, Borek, Aleksandra J, Honeyford, Kate, Welch, John, Brent, Andrew J, Kinderlerer, Anne, Cooke, Graham, Patil, Shashank, Gordon, Anthony, Glampson, Ben, Goodman, Philippa, Ghazal, Peter ORCID: https://orcid.org/0000-0003-0035-2228, Daniels, Ron, Costelloe, Céire E and Tonkin-Crine, Sarah 2024. Views and uses of sepsis digital alerts in National Health Service Trusts in England: Qualitative study with health care professionals. JMIR Human Factors 11 , e56949. 10.2196/56949

[thumbnail of humanfactors-2024-1-e56949.pdf] PDF - Published Version
Available under License Creative Commons Attribution.

Download (249kB)

Abstract

Sepsis is a common cause of serious illness and death. Sepsis management remains challenging and suboptimal. To support rapid sepsis diagnosis and treatment, screening tools have been embedded into hospital digital systems to appear as digital alerts. The implementation of digital alerts to improve the management of sepsis and deterioration is a complex intervention that has to fit with team workflow and the views and practices of hospital staff. Despite the importance of human decision-making and behavior in optimal implementation, there are limited qualitative studies that explore the views and experiences of health care professionals regarding digital alerts as sepsis or deterioration computerized clinician decision support systems (CCDSSs). This study aims to explore the views and experiences of health care professionals on the use of sepsis or deterioration CCDSSs and to identify barriers and facilitators to their implementation and use in National Health Service (NHS) hospitals. We conducted a qualitative, multisite study with unstructured observations and semistructured interviews with health care professionals from emergency departments, outreach teams, and intensive or acute units in 3 NHS hospital trusts in England. Data from both interviews and observations were analyzed together inductively using thematic analysis. A total of 22 health care professionals were interviewed, and 12 observation sessions were undertaken. A total of four themes regarding digital alerts were identified: (1) support decision-making as nested in electronic health records, but never substitute professionals' knowledge and experience; (2) remind to take action according to the context, such as the hospital unit and the job role; (3) improve the alerts and their introduction, by making them more accessible, easy to use, not intrusive, more accurate, as well as integrated across the whole health care system; and (4) contextual factors affecting views and use of alerts in the NHS trusts. Digital alerts are more optimally used in general hospital units with a lower senior decision maker:patient ratio and by health care professionals with experience of a similar technology. Better use of the alerts was associated with quality improvement initiatives and continuous sepsis training. The trusts' features, such as the presence of a 24/7 emergency outreach team, good technological resources, and staffing and teamwork, favored a more optimal use. Trust implementation of sepsis or deterioration CCDSSs requires support on multiple levels and at all phases of the intervention, starting from a prego-live analysis addressing organizational needs and readiness. Advancements toward minimally disruptive and smart digital alerts as sepsis or deterioration CCDSSs, which are more accurate and specific but at the same time scalable and accessible, require policy changes and investments in multidisciplinary research. [Abstract copyright: ©Runa Lazzarino, Aleksandra J Borek, Kate Honeyford, John Welch, Andrew J Brent, Anne Kinderlerer, Graham Cooke, Shashank Patil, Anthony Gordon, Ben Glampson, Philippa Goodman, Peter Ghazal, Ron Daniels, Céire E Costelloe, Sarah Tonkin-Crine. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 15.10.2024.]

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Medicine
Publisher: JMIR Publications
Date of First Compliant Deposit: 28 October 2024
Date of Acceptance: 11 July 2024
Last Modified: 28 Oct 2024 09:45
URI: https://orca.cardiff.ac.uk/id/eprint/173429

Actions (repository staff only)

Edit Item Edit Item

Downloads

Downloads per month over past year

View more statistics