Chapter 1 - Approaching Clinical Decision Support in Medication Management
INTRODUCTION
- Begin by developing a clear picture of central processes and concepts, such as the medication management cycle, CDS intervention types, and challenges and opportunities related to medication management.
- Consider how the “CDS Five Rights” apply to improving processes related to medication use and outcomes throughout the medication management cycle.
- Take a broad perspective on opportunities to support end users with CDS; the toolkit contains many important CDS tools in addition to interruptive alerts and reminders.
- Go into your efforts bearing in mind what optimal, CDS-facilitated medication management might look like.
How well are tasks related to the medication use cycle typically accomplished in healthcare delivery today? Because you are reading this book, you probably sense that there is vast opportunity for improvement. Each step in the medication management process is fraught with opportunities for suboptimal outcomes, even with the best trained/educated/intended participants. CDS interventions offer promise for shoring up many of these weak spots. In typical practice today, however, CDS is used in relatively few components of the medication management process and is generally not optimally executed. A recent report from The Institute of Medicine (IOM) (see 'Summary of the 2006 IOM Report on Medication Errors') hints at the extensive opportunity for improvement.
To set the stage for the CDS implementation guidance offered in the remainder of this book, this chapter will walk you through the following related elements:
- The Five Rights of CDS – a framework for supporting clinical decisions to improve outcomes
- How CDS can be applied within the medication management cycle
- The types of CDS interventions that can be used to support medication management
- How key terms are used in this book
This chapter also briefly summarizes the current state of medication management to help you place your environment and challenges within a broader context. We provide a glimpse of a future characterized by more optimal CDS-enhanced medication management to inspire and guide your improvement efforts. We conclude this chapter with a literature sampling on medication errors and CDS in medication management as a springboard for those interested in deeper research on these topics.
© 2009 Healthcare Information Management Systems Society (HIMSS)