PMID- 35244165
OWN - NLM
STAT- MEDLINE
DCOM- 20220517
LR  - 20230929
IS  - 1527-974X (Electronic)
IS  - 1067-5027 (Print)
IS  - 1067-5027 (Linking)
VI  - 29
IP  - 6
DP  - 2022 May 11
TI  - Clinician collaboration to improve clinical decision support: the Clickbusters 
      initiative.
PG  - 1050-1059
LID - 10.1093/jamia/ocac027 [doi]
AB  - OBJECTIVE: We describe the Clickbusters initiative implemented at Vanderbilt 
      University Medical Center (VUMC), which was designed to improve safety and 
      quality and reduce burnout through the optimization of clinical decision support 
      (CDS) alerts. MATERIALS AND METHODS: We developed a 10-step Clickbusting process 
      and implemented a program that included a curriculum, CDS alert inventory, 
      oversight process, and gamification. We carried out two 3-month rounds of the 
      Clickbusters program at VUMC. We completed descriptive analyses of the changes 
      made to alerts during the process, and of alert firing rates before and after the 
      program. RESULTS: Prior to Clickbusters, VUMC had 419 CDS alerts in production, 
      with 488 425 firings (42 982 interruptive) each week. After 2 rounds, the 
      Clickbusters program resulted in detailed, comprehensive reviews of 84 CDS alerts 
      and reduced the number of weekly alert firings by more than 70 000 (15.43%). In 
      addition to the direct improvements in CDS, the initiative also increased user 
      engagement and involvement in CDS. CONCLUSIONS: At VUMC, the Clickbusters program 
      was successful in optimizing CDS alerts by reducing alert firings and resulting 
      clicks. The program also involved more users in the process of evaluating and 
      improving CDS and helped build a culture of continuous evaluation and improvement 
      of clinical content in the electronic health record.
CI  - (c) The Author(s) 2022. Published by Oxford University Press on behalf of the 
      American Medical Informatics Association.
FAU - McCoy, Allison B
AU  - McCoy AB
AUID- ORCID: 0000-0003-2292-9147
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Russo, Elise M
AU  - Russo EM
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Johnson, Kevin B
AU  - Johnson KB
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
AD  - Department of Pediatrics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Addison, Bobby
AU  - Addison B
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Patel, Neal
AU  - Patel N
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
AD  - Department of Pediatrics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Wanderer, Jonathan P
AU  - Wanderer JP
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
AD  - Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Mize, Dara E
AU  - Mize DE
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
AD  - Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, 
      Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Jackson, Jon G
AU  - Jackson JG
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Reese, Thomas J
AU  - Reese TJ
AUID- ORCID: 0000-0002-1081-1670
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Littlejohn, SyLinda
AU  - Littlejohn S
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Patterson, Lorraine
AU  - Patterson L
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - French, Tina
AU  - French T
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Preston, Debbie
AU  - Preston D
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Rosenbury, Audra
AU  - Rosenbury A
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Valdez, Charlie
AU  - Valdez C
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Nelson, Scott D
AU  - Nelson SD
AUID- ORCID: 0000-0002-1941-1817
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Aher, Chetan V
AU  - Aher CV
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
AD  - Department of General Surgery, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Alrifai, Mhd Wael
AU  - Alrifai MW
AUID- ORCID: 0000-0003-0761-4905
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
AD  - Department of Pediatrics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Andrews, Jennifer
AU  - Andrews J
AD  - Department of Pediatrics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
AD  - Department of Pathology, Microbiology and Immunology, Vanderbilt University 
      Medical Center, Nashville, Tennessee, USA.
FAU - Cobb, Cheryl
AU  - Cobb C
AD  - Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical 
      Center, Nashville, Tennessee, USA.
FAU - Horst, Sara N
AU  - Horst SN
AD  - Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, 
      Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Johnson, David P
AU  - Johnson DP
AUID- ORCID: 0000-0001-6689-8229
AD  - Department of Pediatrics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Knake, Lindsey A
AU  - Knake LA
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - Department of Pediatrics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Lewis, Adam A
AU  - Lewis AA
AD  - Vanderbilt Institute for Clinical and Translational Research, Vanderbilt 
      University Medical Center, Nashville, Tennessee, USA.
FAU - Parks, Laura
AU  - Parks L
AD  - Nursing Informatics Services, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Parr, Sharidan K
AU  - Parr SK
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
AD  - Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt 
      University Medical Center, Nashville, Tennessee, USA.
FAU - Patel, Pratik
AU  - Patel P
AD  - Union University College of Pharmacy, Memphis, Tennessee, USA.
FAU - Patterson, Barron L
AU  - Patterson BL
AD  - Department of Pediatrics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Smith, Christine M
AU  - Smith CM
AUID- ORCID: 0000-0001-5865-8989
AD  - Department of Pediatrics, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Suszter, Krystle D
AU  - Suszter KD
AD  - Nursing Informatics Services, Vanderbilt University Medical Center, Nashville, 
      Tennessee, USA.
FAU - Turer, Robert W
AU  - Turer RW
AUID- ORCID: 0000-0003-1387-640X
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Wilcox, Lyndy J
AU  - Wilcox LJ
AD  - Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical 
      Center, Nashville, Tennessee, USA.
FAU - Wright, Aileen P
AU  - Wright AP
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Wright, Adam
AU  - Wright A
AD  - Department of Biomedical Informatics, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
AD  - HeathIT, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Am Med Inform Assoc
JT  - Journal of the American Medical Informatics Association : JAMIA
JID - 9430800
SB  - IM
CIN - J Am Med Inform Assoc. 2023 Sep 25;30(10):1754. PMID: 37535817
MH  - *Decision Support Systems, Clinical
MH  - Electronic Health Records
MH  - Humans
MH  - *Medical Order Entry Systems
PMC - PMC9093034
OTO - NOTNLM
OT  - clinical
OT  - decision support systems
OT  - electronic health records
OT  - evaluation study
OT  - quality improvement
OT  - user engagement
EDAT- 2022/03/05 06:00
MHDA- 2022/05/18 06:00
PMCR- 2022/03/04
CRDT- 2022/03/04 08:50
PHST- 2021/04/19 00:00 [received]
PHST- 2022/01/19 00:00 [revised]
PHST- 2022/02/16 00:00 [accepted]
PHST- 2022/03/05 06:00 [pubmed]
PHST- 2022/05/18 06:00 [medline]
PHST- 2022/03/04 08:50 [entrez]
PHST- 2022/03/04 00:00 [pmc-release]
AID - 6542395 [pii]
AID - ocac027 [pii]
AID - 10.1093/jamia/ocac027 [doi]
PST - ppublish
SO  - J Am Med Inform Assoc. 2022 May 11;29(6):1050-1059. doi: 10.1093/jamia/ocac027.