HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Read responses to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Morris, A H Search for Related Content PubMed PubMed Citation Articles by Morris, A H

Decision support and safety of clinical environments

Correspondence to:
Dr A H Morris, Pulmonary Division, LDS Hospital, Salt Lake City, Utah 84143, USA;
amorris{at}ihc.com

ABSTRACT
Safety in the clinical environment is based on structures that reduce the probability of harm, on evidence that enhances the likelihood of actions that increase favourable outcomes, and on explicit directions that lead to decisions to implement the actions dictated by this evidence. A clinical decision error rate of only 1% threatens patient safety at a distressing frequency. Explicit computerised decision support tools standardise clinical decision making and lead different clinicians to the same set of diagnostic or therapeutic instructions. They have favourable impacts on patient outcome. Simple computerised algorithms that generate reminders, alerts, or other information, and protocols that incorporate more complex rules reduce the clinical decision error rate. Decision support tools are not new; it is the new attributes of explicit computerised decision support tools that deserve identification. When explicit computerised protocols are driven by patient data, the protocol output (instructions) is patient specific, thus preserving individualised treatment while standardising clinical decisions. The expected decrease in variation and increase in compliance with evidence-based recommendations should decrease the error rate and enhance patient safety.

Keywords: decision support tools; error; safety

This article has been cited by other articles:

				B. T. Thompson and D. Schoenfeld Usual Care as the Control Group in Clinical Trials of Nonpharmacologic Interventions Proceedings of the ATS, October 1, 2007; 4(7): 577 - 582. [Abstract] [Full Text] [PDF]

				T. K. Harrison, T. Manser, S. K. Howard, and D. M. Gaba Use of cognitive AIDS in a simulated anesthetic crisis. Anesth. Analg., September 1, 2006; 103(3): 551 - 556. [Abstract] [Full Text] [PDF]

				M. A. Kelley, D. Angus, D. B. Chalfin, E. D. Crandall, D. Ingbar, W. Johanson, J. Medina, C. N. Sessler, and J. S. Vender The Critical Care Crisis in the United States: A Report From the Profession Chest, April 1, 2004; 125(4): 1514 - 1517. [Full Text] [PDF]

				A H Morris Iatrogenic illness: a call for decision support tools to reduce unnecessary variation Qual. Saf. Health Care, February 1, 2004; 13(1): 80 - 81. [Full Text]

eLetters: