Table 2 Overview of the GUIDES checklist factors and how to evaluate questions
Question | Strongly disagree | Disagree | Somewhat disagree | Undecided | Somewhat agree | Agree | Strongly agree |
|---|---|---|---|---|---|---|---|
Domain 1: The CDS context | |||||||
1.1. CDS can achieve the planned quality objectives  - Does CDS address the factors that explain the current behaviour of healthcare providers and patients?  - Does the available evidence support the use of CDS for the given outcomes, tasks and settings? | □ | □ | □ | □ | □ | □ | □ |
1.2 The quality of the patient data is sufficient  - Is the structured patient data that is needed to achieve the CDS objective sufficiently accurate and complete to allow the use of CDS?  - If necessary, can the quality of the data be improved or can the CDS itself improve the data quality? | □ | □ | □ | □ | □ | □ | □ |
1.3 Stakeholders and users accept CDS  - Is there a clear benefit to the users who will engage with the CDS?  - Do the users and stakeholders have a positive attitude towards the use of CDS?  - If necessary, is it possible to increase user and stakeholder acceptance? | □ | □ | □ | □ | □ | □ | □ |
1.4 CDS can be added to the existing workload, workflows and systems  - Is the required hardware available and what will the impact be of adding CDS to the existing information systems?  - Is it feasible to introduce CDS, given the current workload and the usual work processes?  - If necessary, can the workload or the work processes be changed or can the CDS system improve the workload or work processes? | □ | □ | □ | □ | □ | □ | □ |
Domain 2: The CDS content | |||||||
2.1 The content provides trustworthy evidence-based information  - Do the organisation(s) and people that developed the decision support have credibility?  - Is the advice supported by up-to-date scientific evidence and is the type and quality of this evidence clear to the user?  - Is the decision support clear on the benefits and harms of the different management options? | □ | □ | □ | □ | □ | □ | □ |
2.2 The decision support is relevant and accurate  - Does the decision support contain accurate information that is pertinent to the care of the patient?  - Does the decision support address the information needs of the users?  - Is it clear to the users why the decision support information is provided for a given patient? | □ | □ | □ | □ | □ | □ | □ |
2.3 The decision support provides an appropriate call to action  - Is the recommended action clear enough for the targeted users to act on?  - Is the clinical importance and urgency of the recommended action sufficiently clear?  - Is the advice applicable in the setting in which it will be implemented?  - Is it clear how the recommended action fits with other current guidelines? | □ | □ | □ | □ | □ | □ | □ |
2.4 The amount of decision support is manageable for the target user  - Is the total amount of decision support manageable for the healthcare provider?  - Is the amount of decision support per patient manageable? | □ | □ | □ | □ | □ | □ | □ |
Domain 3: The CDS system | |||||||
3.1 The system is easy to use  - Is it easy for users to interact with the CDS system?  - Does the system facilitate (or, at least, not hinder) the workflow of the healthcare providers?  - Can the system be customised to provide better user support  - Is the system always up and running? | □ | □ | □ | □ | □ | □ | □ |
3.2 The decision support is well delivered  - Is the advice delivered in an appropriate mode, format and channel?  - Is the display of the decision support eye-catching, intuitive, concise, consistent and unambiguous?  - Is it appropriate to use specific functions (e.g. pop-ups, computerised restrictions, indications of (dis)agreement) for prioritised decision support? | □ | □ | □ | □ | □ | □ | □ |
3.3 The system delivers the decision support to the right target person  - Is the system reaching the targeted users (healthcare providers and/or patients)?  - Is the system able to facilitate team processes when these are needed? | □ | □ | □ | □ | □ | □ | □ |
3.4 The decision support is available at the right time  - Does the system provide the decision support at a moment of need? | □ | □ | □ | □ | □ | □ | □ |
Domain 4: The CDS implementation | |||||||
4.1 Information to users about the CDS and its functions is appropriate  - Is the communication and documentation about the CDS appropriate?  - Are help topics related to the functioning of the CDS system available to users?  - If necessary, is user training available? | □ | □ | □ | □ | □ | □ | □ |
4.2 Other barriers and facilitators to compliance with the decision support advice are assessed/addressed  - Is there an assessment of the beliefs, attitudes and skills of the healthcare providers and patients that may affect adherence to the decision support advice? Are actions planned/taken accordingly?  - Is there an assessment of the professional interactions affecting adherence to the recommended actions, and are actions planned/taken accordingly?  - Is there an assessment of the (dis)incentives affecting the adherence of healthcare providers and patients to the decision support advice? Are necessary actions planned/taken?  - Is there an assessment of the issues related to the capacity and resources needed to ensure adherence to the recommended actions? Are the necessary actions planned/taken?  - Does the organisational context influence adherence to the decision support advice and what are actions planned/taken accordingly? | □ | □ | □ | □ | □ | □ | □ |
4.3 Implementation is stepwise and the improvements in the CDS system are continuous  - Is the implementation of the CDS stepwise?  - Is a plan in place to collect user feedback and to monitor system usage, performance and outcomes?  - Are malfunctions and other problems with use of the CDS quickly fixed? | □ | □ | □ | □ | □ | □ | □ |
4.4 Governance of the CDS implementation is appropriate  - Are all the key stakeholders involved in the planning and implementation of the system?  - Is the CDS initiative governed in an efficient, sustainable and equitable way? | □ | □ | □ | □ | □ | □ | □ |