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Appl Clin Inform 2022; 13(03): 647-655
DOI: 10.1055/s-0042-1750360
Research Article

Clinical Decision Support for Fall Prevention: Defining End-User Needs

Hannah Rice
1   Department of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Boston, Massachusetts, United States
,
Pamela M. Garabedian
2   Department of Information Systems, Mass General Brigham, Boston, Massachusetts, United States
,
Kristen Shear
3   Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida, United States
,
Ragnhildur I. Bjarnadottir
3   Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida, United States
,
Zoe Burns
1   Department of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Boston, Massachusetts, United States
,
Nancy K. Latham
4   Research Program in Men's Health: Aging and Metabolism, Brigham & Women's Hospital, Boston, Massachusetts, United States
,
Denise Schentrup
3   Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida, United States
,
Robert J. Lucero
3   Department of Family, Community, and Health Systems Science, University of Florida College of Nursing, Gainesville, Florida, United States
5   School of Nursing, University of California, Los Angeles, Los Angeles, California, United States
,
Patricia C. Dykes
1   Department of General Internal Medicine and Primary Care, Brigham & Women's Hospital, Boston, Massachusetts, United States
6   Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations Funding This research was supported by the Agency for Healthcare Research and Quality under award number 5U18HS027557-02. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
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Abstract

Background and Significance Falls in community-dwelling older adults are common, and there is a lack of clinical decision support (CDS) to provide health care providers with effective, individualized fall prevention recommendations.

Objectives The goal of this research is to identify end-user (primary care staff and patients) needs through a human-centered design process for a tool that will generate CDS to protect older adults from falls and injuries.

Methods Primary care staff (primary care providers, care coordinator nurses, licensed practical nurses, and medical assistants) and community-dwelling patients aged 60 years or older associated with Brigham & Women's Hospital-affiliated primary care clinics and the University of Florida Health Archer Family Health Care primary care clinic were eligible to participate in this study. Through semi-structured and exploratory interviews with participants, our team identified end-user needs through content analysis.

Results User needs for primary care staff (n = 24) and patients (n = 18) were categorized under the following themes: workload burden; systematic communication; in-person assessment of patient condition; personal support networks; motivational tools; patient understanding of fall risk; individualized resources; and evidence-based safe exercises and expert guidance. While some of these themes are specific to either primary care staff or patients, several address needs expressed by both groups of end-users.

Conclusion Our findings suggest that there are many care gaps in fall prevention management in primary care and that personalized, actionable, and evidence-based CDS has the potential to address some of these gaps.

Keywords

clinical decision support - primary care - human-centered design - user needs - falls

Protection of Human and Animal Subjects

This study was approved by Partners HealthCare Humans Research Committee under protocol number 2020P002075. The committee granted implied consent by voluntary participation in the study.


Author Contributions

P.M.G., R.I.B., N.K.L., R.J.L., D.S., and P.C.D. were involved in the design of the study. H.R., P.M.G., and K.S. were involved in the coding of the data. All authors were involved in the analysis of the data. H.R. and P.M.G wrote the manuscript. All authors read and approved the final manuscript.


Supplementary Material



Publication History

Received: 31 January 2022

Accepted: 04 May 2022

Article published online:
29 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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