Hospital antimicrobial stewardship team perceptions and usability of a computerized clinical decision support system

This is the authors' abstract. We don't add key points for this paper.

• What was already known on the topic: • Commercial computerized clinical decision support systems (CDSSs) propose more practical solutions for antimicrobial stewardship team than in-house CDSSs built by hospital teams. • Adoption of new health information systems in hospital depends on technical, organizational and human factors. • CDSS development requires involvement of mixed clinical and information technology teams. • What this study added to our knowledge: • CDSSs are valuable systems to support antimicrobial stewardship activities. • The antimicrobial stewardship team highlighted benefits about the CDSS use which improved their clinical practices and the quality of care of patients. • The adoption of a CDSS requires time, involvement, availability, training and adaptability of the user team. Antimicrobial stewardship (AMS) programs aim to optimize antibiotic use through a panel of interventions. The implementation of computerized clinical decision support systems (CDSSs) offers new opportunities for semiautomated antimicrobial review by AMS teams. This study aimed to evaluate the perceived facilitators, barriers and benefits of end-users related to a commercial CDSS recently implemented in a hospital and to assess its usability. A mixed-method approach was used among AMS team members nine months after the implementation of the CDSS in a university hospital in northeastern France. A qualitative analysis based on individual semistructured interviews was conducted to collect end-users’ perceptions. A quantitative analysis was performed using the System Usability Scale (SUS). Eleven AMS team members agreed to participate. The qualitative analysis revealed technical, organizational and human barriers and facilitators of CDSS implementation. Effective collaboration with information technology teams was crucial for ensuring the installation and configuration of the software. CDSS adoption by the AMS team required time, human resources, training, adaptation and a clinical leader. Moreover, the CDSS had to be well designed, user-friendly and provide benefits to AMS activities. The quantitative analysis indicated that the CDSS was a “good” system in terms of perceived ease of use (median SUS score: 77.5/100). This study shows the value of the studied CDSS to support AMS activities. It reveals barriers, facilitators and benefits to the implementation and adoption of the CDSS. These barriers and facilitators could be considered to facilitate the implementation of the software in other hospitals.