title: Understanding a VA preventive care clinical reminder: lessons learned.
abstract: This article presents "lessons learned" about using a computerized clinical reminder (CCR) for influenza in spinal cord injury (SCI) centers in the Veterans Health Administration (VHA). Although research has shown that use of a CCR increases adherence to preventive care measures, technical and administrative issues affect its use by nurses. CCR is a term for a reminder in a patient's electronic medical record to initiate a preventive care activity. Qualitative data about using the CCR for influenza were collected from staff using semi-structured interviews, e-mail questionnaires, and telephone calls. Once issues were identified, follow-up activities included discussions with local and national experts and problem-solving activities. The investigators identified two national issues about the CCR for influenza: the taxonomy to identify patients with SCI, and the "due date" for influenza vaccine. Local issues included authorization for nurses to use the CCR, ease of use of the CCR for inpatients and outpatients, connectivity of the medication tracking program for inpatients with the electronic medical record, configuration of the CCR in the electronic medical record, training, and technical support.
authors.affiliation: VA Spinal Cord Injury Quality Enhancement Research Initiative, Health Services Research and Development, VA Puget Sound Health Care System, Seattle, Washington, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Wallace
authors.forename: Michael
authors.initials: M
authors.lastname: Hatzakis
authors.forename: Marcia W
authors.initials: MW
authors.lastname: Legro
authors.forename: Barry
authors.initials: B
authors.lastname: Goldstein
mesh_terms: D000359:Aftercare; D001291:Attitude of Health Personnel; D006801:Humans; D007251:Influenza, Human / Q000209:etiology / Q000517:prevention & control*; D024802:Nurse's Role; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D015397:Program Evaluation; D036301:Qualitative Research; D012042:Registries; D017010:Reminder Systems / Q000592:standards*; D013119:Spinal Cord Injuries / Q000150:complications / Q000451:nursing / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014611:Vaccination / Q000451:nursing / Q000523:psychology / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data