MODULE 5: Decision Support for Care Delivery

Something new I learned in this module is the word "heuristics". Listening to Kahneman on YouTube and reading his article about heuristics, gave me a good dose of realization that most people like myself have unknowingly used heuristics and biases with decision making. There have been times where my decisions were based on my previous experiences, common practices and intuition.  Oftentimes, the outcomes are desirable. At other times, the outcomes are less than desirable.

Information technology has been instrumental in the collection of expert knowledge and information at our fingertips. Nursing and medicine have been some of the recipients of such positive contribution of informatics with one in particular, the clinical decision support system. Studies about the effectiveness in clinical decision support systems in cost-effectiveness and improve patient outcomes have all been positive (Anderson & Willson, 2008).  Patient safety has been impacted because of its portability at the point of care and the quality of information and knowledge that are easily accessed by the clinician. With so much information and knowledge it is impossible to remember them all. Clinical decision support systems are wonderful tools when utilized at the point of care (Hebda, 2009).

Unfortunately widespread use is still in its infancy. There are costs involved with having the system and training the staff to utilizing the system. With the incredibly expensive cost of medical errors (both monetarily and in human lives), the cost of CDS's should never even be given second thought. I have worked in a nursing home the first several years of my nursing career and saw firsthand how devastating pressure ulcers are on the quality of life of the residents. With the availability of pressure relief surfaces and more evidence-based knowledge in wound healing, in addition to CDS, there will hopefully be less incidence of pressure ulcer occurence in bedbound patients. Decision making in my clinical practice would truly be patient-centered and quality-based care if CDS system is used in addition to my clinical knowledge and training.