title: Clinical decision support system (CDSS)--effects on care quality.
abstract: OBJECTIVE
  Despite their efficacy, some recommended therapies are underused. The purpose of this paper is to describe clinical decision support system (CDSS) development and its impact on clinical guideline adherence.
  
  
  METHODS
  A new CDSS was developed and introduced in a cardiac intensive care unit (CICU) in 2003, which provided physicians with patient-tailored reminders and permitted data export from electronic patient records into a national quality registry. To evaluate CDSS effects in the CICU, process indicators were compared to a control group using registry data. All CICUs were in the same region and only patients with acute coronary syndrome were included.
  
  
  RESULTS
  CDSS introduction was associated with increases in guideline adherence, which ranged from 16 to 35 per cent, depending on the therapy. Statistically significant associations between guideline adherence and CDSS use remained over the five-year period after its introduction. During the same period, no relapses occurred in the intervention CICU.
  
  
  CONCLUSIONS
  Guideline adherence and healthcare quality can be enhanced using CDSS. This study suggests that practitioners should turn to CDSS to improve healthcare quality.
  
  
  CONCLUSIONS
  This paper describes and evaluates an intervention that successfully increased guideline adherence, which improved healthcare quality when the intervention CICU was compared to the control group.
authors.forename: Marco António Ferreira Rodrigues Nogueira
authors.initials: MA
authors.lastname: dos Santos
authors.forename: Hans
authors.initials: H
authors.lastname: Tygesen
authors.forename: Henrik
authors.initials: H
authors.lastname: Eriksson
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D017410:Practice Guidelines as Topic; D058996:Quality Improvement / Q000458:organization & administration*; D012959:Socioeconomic Factors; D013548:Sweden
chemical_list: D002317:Cardiovascular Agents