Clinical informatics case study. Computerized protocols for ventilator management in ARDS patients. Case study.

The implementation of the computerized protocol for mechanical ventilation management should be considered successful. Of the 11 sites, only 4 encountered major difficulties. One site could be considered an implementation failure. At this site the protocol software, which was loaded onto the existing computerized patient documentation system, did not initially function smoothly and it severely affected the trust at the clinical site. At the other three sites system usage was minimal due to time requirements of the study rather than a failure to accept the decision support system. Implementation methods suggested by authors such as Whitten and Bentley were found to be successful. Methods of particular use included obtaining buy-in of key personnel, contacting and working with IS personnel early in the project, providing adequate training and reference materials for clinical and support personnel, and providing extra training for some users, thereby creating a "super-user" role. Finally, factors for success of a clinical trial to evaluate a decision support system are slightly different from those for successful use of the system. Time necessary for research functions such as patient screening and recruitment must be considered at the outset and planned for accordingly.