• Adam C Dziorny, Julia A Heneghan, Moodakare Ashwini Bhat, Dean J Karavite, L Nelson Sanchez-Pinto, Jennifer McArthur, Naveen Muthu, and Pediatric Data Science and Analytics (PEDAL) Subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network.
• Department of Pediatrics & Biomedical Engineering, University of Rochester School of Medicine, Rochester, NY.
• Pediatr Crit Care Me. 2022 Aug 1; 23 (8): e392-e396.

ObjectivesTo assess the current landscape of clinical decision support (CDS) tools in PICUs in order to identify priority areas of focus in this field.DesignInternational, quantitative, cross-sectional survey.SettingRole-specific, web-based survey administered in November and December 2020.SubjectsMedical directors, bedside nurses, attending physicians, and residents/advanced practice providers at Pediatric Acute Lung Injury and Sepsis Network-affiliated PICUs.InterventionsNone.Measurements And Main ResultsThe survey was completed by 109 respondents from 45 institutions, primarily attending physicians from university-affiliated PICUs in the United States. The most commonly used CDS tools were people-based resources (93% used always or most of the time) and laboratory result highlighting (86%), with order sets, order-based alerts, and other electronic CDS tools also used frequently. The most important goal providers endorsed for CDS tools were a proven impact on patient safety and an evidence base for their use. Negative perceptions of CDS included concerns about diminished critical thinking and the burden of intrusive processes on providers. Routine assessment of existing CDS was rare, with infrequent reported use of observation to assess CDS impact on workflows or measures of individual alert burden.ConclusionsAlthough providers share some consensus over CDS utility, we identified specific priority areas of research focus. Consensus across practitioners exists around the importance of evidence-based CDS tools having a proven impact on patient safety. Despite broad presence of CDS tools in PICUs, practitioners continue to view them as intrusive and with concern for diminished critical thinking. Deimplementing ineffective CDS may mitigate this burden, though postimplementation evaluation of CDS is rare.Copyright © 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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