A Qualitative Study Examining Clinical Decision Support System Adoption Among Hospital Clinicians

NCT07398235 | Completed

• 2 other identifiers: 1366IRAS ID: 365984
• Study Type: observational
• Target: 18
• Locations: 1 country
• Sites: 1

Brief Summary

A Qualitative Study to Explore the Barriers to Adoption of Clinical Decision Support Systems

Conditions

Clinical Decision Support System (CDSS)

Outcome Measures

Primary Outcomes (1)

• Saturation of Themes Related to Barriers to CDSS Adoption

  The primary outcome examines the barriers to clinical decision support system adoption, such as hardware issues, governance concerns, user-interface problems, and trusted information. These themes will be examined during interviews with open-ended questions to allow user experiences to be recorded. This study will use purposive sampling with maximum variation to ensure representation across key categories of Emergency Department clinicians who use clinical decision support systems (CDSS). Participants will be selected to capture a range of roles and experiences, including Advanced Clinical Practitioners (ACPs), Physician Associates (PAs), Clinical Support Workers (CSWs), nurses, and doctors at different levels (Foundation Year 1-2, Senior House Officers, Registrars, and Consultants). Recruitment will continue until data saturation of themes related to CDSS adoption is achieved within and across these categories, anticipated at approximately one to two participants per role group.

  The study ran between 10th January 2026 until 31 January 2026. The study was considered complete once all planned participant interviews have been conducted or recruitment has formally ceased following achievement of data saturation.

Study Arms (8)

FY1/2

Foundation Year 1 \& 2 Doctors

Other: Semi-structured interview

SHO

Senior House Officer level doctor above FY2 but below Registrar

Other: Semi-structured interview

Registrar

Registrar level doctor

Other: Semi-structured interview

Consultant

Consultant level doctor

Other: Semi-structured interview

Physician Assistant

Physician Assistant clinician

Other: Semi-structured interview

ACP

Advanced Clinical Practitioner

Other: Semi-structured interview

CSW

Clinical Support Worker

Other: Semi-structured interview

Nurse

Registered Nurse

Other: Semi-structured interview

Interventions

Semi-structured interview OTHER

A 20-30 minute semi-structured interview using the pre-defined topic sheet

ACP; CSW; Consultant; FY1/2; Nurse; Physician Assistant; Registrar; SHO

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Hospital clinicians employed by Medway NHS Foundation Trust

You may qualify if:

• Employed by Medway NHS Foundation Trust at the time of recruitment
• Working clinically within the Emergency Department
• Clinical grade of FY1, FY2, SHO/CTF, SAS/Registrar, Consultant, Nurse, Advanced Clinical practitioner, Physician Assistant, or Clinical Support Worker
• Involved in the assessment and management of adult emergency department patients
• Have routine access to the Trust electronic patient record system (Sunrise EPR) during clinical duties
• Able to provide informed consent to participate
• Aged 18 years or older

You may not qualify if:

• Bank, agency, or locum staff who are not permanently or regularly employed by the department.
• Staff currently on leave, secondment, or not actively practising in the ED during the data collection period.
• Clinicians currently involved in the design, management, or evaluation of the CDSS system under study.

Sponsors & Collaborators

• Medway NHS Foundation Trust: lead

Study Sites (1)

Medway NHS Foundation Trust

Gillingham, Kent, ME7 5NY, United Kingdom

Location

Related Publications (5)

• Mebrahtu TF, Skyrme S, Randell R, Keenan AM, Bloor K, Yang H, Andre D, Ledward A, King H, Thompson C. Effects of computerised clinical decision support systems (CDSS) on nursing and allied health professional performance and patient outcomes: a systematic review of experimental and observational studies. BMJ Open. 2021 Dec 15;11(12):e053886. doi: 10.1136/bmjopen-2021-053886.

  PMID: 34911719 BACKGROUND

• Meunier PY, Raynaud C, Guimaraes E, Gueyffier F, Letrilliart L. Barriers and Facilitators to the Use of Clinical Decision Support Systems in Primary Care: A Mixed-Methods Systematic Review. Ann Fam Med. 2023 Jan-Feb;21(1):57-69. doi: 10.1370/afm.2908.

  PMID: 36690490 BACKGROUND

• Chen W, O'Bryan CM, Gorham G, Howard K, Balasubramanya B, Coffey P, Abeyaratne A, Cass A. Barriers and enablers to implementing and using clinical decision support systems for chronic diseases: a qualitative systematic review and meta-aggregation. Implement Sci Commun. 2022 Jul 28;3(1):81. doi: 10.1186/s43058-022-00326-x.

  PMID: 35902894 BACKGROUND

• Liberati EG, Ruggiero F, Galuppo L, Gorli M, Gonzalez-Lorenzo M, Maraldi M, Ruggieri P, Polo Friz H, Scaratti G, Kwag KH, Vespignani R, Moja L. What hinders the uptake of computerized decision support systems in hospitals? A qualitative study and framework for implementation. Implement Sci. 2017 Sep 15;12(1):113. doi: 10.1186/s13012-017-0644-2.

  PMID: 28915822 BACKGROUND

• Sutton RT, Pincock D, Baumgart DC, Sadowski DC, Fedorak RN, Kroeker KI. An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ Digit Med. 2020 Feb 6;3:17. doi: 10.1038/s41746-020-0221-y. eCollection 2020.

  PMID: 32047862 BACKGROUND

Related Links

• 10 Year Health Plan for England (Department of Health and Social Care)
• Independent Investigation of the NHS in England (Department of Health and Social Care)
• Supporting clinical decisions with health information technology: An implementation guide for clinical decision support systems (NHS England)

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Chief Investigator

Study Record Dates

• First Submitted: January 19, 2026
• First Posted: February 9, 2026
• Study Start: January 10, 2026
• Primary Completion: January 31, 2026
• Study Completion: March 16, 2026
• Last Updated: May 18, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)