Approaching the CDS Intervention Configuration Template
Template Structure
The template has 2 main sections: header information that documents a) the improvement target, b) related performance data, and c) notes about where and how you plan to use the template; and a 3-part tool for documenting CDS configuration details. These 3 parts provide a:
Image by Tungphoto / Free Digital Photos.net
Populating the Template
Step 1: Identify Improvement Target
When completing the CDS configuration template, it is important to identify up front the improvement target and the data you will use to track performance. The details may evolve as the template is used with other local stakeholders. The template specifically asks for:
Target= [specify improvement target]
Performance= [record available data about care processes and outcomes pertinent to your target. Data will change over time, so note date.]
Step 1a: Identify Template Venue/Use
Slightly different versions of the template can be used in different venues for different purposes. It is helpful, for both internal documentation and use as well as inter-organizational sharing, to document the details of when/why/how a particular template version is being used. See below.
Plan for using template: [meeting/conversation, etc.]
Will present at:
With whom:
Toward what end:
When:
Step 2: Generic Workflow Backbone and Sample CDS Interventions
The generic workflow immediately below was designed to apply to inpatient and outpatient care, including managing population health; pilot project participants used it in their efforts.
The purpose of presenting the workflow as a process flow is to help orient stakeholders to the opportunities to apply CDS interventions to improve the targeted outcome. The backbone is an idealized model - actual workflows may include slightly different activities or sequences. Users are welcome to ignore boxes or reorder them as they document their target-focused CDS configuration.
Note that there are samples of CDS workflow interventions in the rounded boxes below the square-edged boxes to help you identify CDS configurations that are currently in place, as well as those that are potentially promising, but not yet implemented.
This ‘workflow backbone’ underpins the two additional CDS configuration documentation templates sections provided later on this webpage (see steps 3 and 4 below). These subsequent template sections layer on top of the generic workflow, the decisions/actions/activities that pertain more specifically to the improvement target.
The Collaborative also developed another draft workflow backbone intended to apply more specifically to the outpatient setting (see second diagram below) - and populated it generically for the 'ABCS' targets (Aspirin use, BP and Cholesterol control, Smoking cessation) in the Million Hearts cardiovascular risk reduction initiative. Although not (yet) used by Collaborative participants, you might find this outpatient-focused workflow backbone useful in your efforts.
In some cases it might be helpful to create a workflow diagram that's anchored by care delivery team roles rather than generic workflow steps. Below is an example of how such a process flow diagram might look. These diagrams can be created by various flowcharting tools.
From: Osheroff, Teich Levick et al. Improving Outcomes with Clinical Decision Support: an implementer's guide. Second edition. HIMSS. 2012.
Step 3: Target-related Workflow and Corresponding CDS Interventions - Summary View
The template section below builds on the generic workflow backbone to enable users to describe – at a summary level - their target-focused workflow and corresponding CDS intervention configuration.
This documentation can facilitate internal stakeholder conversations about CDS goals and approach, help enhance CDS planning, and enable information sharing with other organizations that are implementing CDS interventions for the same target.
Note that the template allows the user to document CDS interventions that are currently implemented (third column), as well as those that are potentially promising, but not in yet place (fourth column).
The template sample below (which shows only part of this template portion) is pre-loaded with sample data for VTE prophylaxis, and it can be adapted for your target and CDS approach.
Step 4: CDS 5 Rights Table View
The template section below builds on the Summary View above by documenting additional details about the various interventions in your target-focused CDS package, particularly details about all the CDS 5 Rights dimensions for each intervention (when, what, how, who, where).
As with the Summary View, it is organized around the workflow steps, which are presented in the second column of the table
To use this template section, record the target and current performance at the top of this form, as you did for the previous template section (Summary View). Then, each row represents an intervention in the package, applied at one workflow step
For further details and annotations on this template section, see the master template attached at the bottom of this webpage.
Step 5: Sharing Completed Templates
Members of the CDS/PI Collaborative are sharing their completed templates on a page in the private Collaborative website and discussing them in the private project discussion group.