title: Exploring sub-optimal use of an electronic risk assessment tool for venous thromboembolism.
abstract: International guidelines and consensus groups recommend using a risk assessment tool (RAT) to assess Venous Thromboembolism (VTE) risk prior to the prescription of prophylaxis. We set out to examine how an electronic RAT was being used (i.e. if by the right clinician, at the right time, for the right purpose) and to identify factors influencing utilization of the RAT. A sample of 112 risk assessments was audited and 12 prescribers were interviewed. The RAT was used as intended in only 40 (35.7%) cases (i.e. completed by a doctor within 24 h of admission, prior to the prescription of prophylaxis). We identified several reasons for sub-optimal use of the RAT, including beliefs about the need for a RAT, poor awareness of the tool, and poor RAT design. If a user-centred approach had been adopted, it is likely that a RAT would not have been implemented or that problematic design issues would have been identified.
authors.affiliation: Centre for Health Systems & Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia; Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia. Electronic address: melissa.baysari@mq.edu.au.
authors.forename: Melissa T
authors.initials: MT
authors.lastname: Baysari
authors.affiliation: Vascular Medicine, St Vincent's Hospital, Sydney, Australia.
authors.forename: Nicola
authors.initials: N
authors.lastname: Jackson
authors.affiliation: Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia.
authors.forename: Sheena
authors.initials: S
authors.lastname: Ramasamy
authors.affiliation: Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia.
authors.forename: Priscila
authors.initials: P
authors.lastname: Santiago
authors.affiliation: Centre for Health Systems & Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
authors.forename: Juan
authors.initials: J
authors.lastname: Xiong
authors.affiliation: Centre for Health Systems & Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
authors.forename: Johanna
authors.initials: J
authors.lastname: Westbrook
authors.affiliation: Vascular Medicine, St Vincent's Hospital, Sydney, Australia.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Omari
authors.affiliation: Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia; St Vincent's Clinical School, UNSW Medicine, UNSW, Sydney, Australia.
authors.forename: Richard O
authors.initials: RO
authors.lastname: Day
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D017064:Process Assessment, Health Care; D018570:Risk Assessment / Q000379:methods / Q000592:standards*; D014584:User-Computer Interface; D054556:Venous Thromboembolism
keywords: Electronic risk assessment tool; VTE prophylaxis; Venous thromboembolism