Abstract
BackgroundThe Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) is an international collaborative project with the overall objective of standardizing the approach to the evaluation and treatment of critically ill patients world-wide, in accordance with best-practice principles. One of CERTAIN’s key features is clinical decision support providing point-of-care information about common acute illness syndromes, procedures, and medications in an index card format.MethodsThis paper describes 1) the process of developing and validating the content for point-of-care decision support, and 2) the content management system that facilitates frequent peer-review and allows rapid updates of content across different platforms (CERTAIN software, mobile apps, pdf-booklet) and different languages.ResultsContent was created based on survey results of acute care providers and validated using an open peer-review process. Over a 3 year period, CERTAIN content expanded to include 67 syndrome cards, 30 procedure cards, and 117 medication cards. 127 (59 %) cards have been peer-reviewed so far. Initially MS Word® and Dropbox® were used to create, store, and share content for peer-review. Recently Google Docs® was used to make the peer-review process more efficient. However, neither of these approaches met our security requirements nor has the capacity to instantly update the different CERTAIN platforms.ConclusionAlthough we were able to successfully develop and validate a large inventory of clinical decision support cards in a short period of time, commercially available software solutions for content management are suboptimal. Novel custom solutions are necessary for efficient global point of care content system management.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0367-3) contains supplementary material, which is available to authorized users.
Highlights
The Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) is an international collaborative project with the overall objective of standardizing the approach to the evaluation and treatment of critically ill patients world-wide, in accordance with best-practice principles
CERTAIN may be beneficial in low-resource settings with a scarcity of formally trained personnel [6]
A priori we postulated that an ideal content management system for CERTAIN should have the following characteristics: Content The content should cover a wide variety of clinically important topics, be easy to read, contain useful point of care information based on up-to-date evidence and be validated by expert reviewers
Summary
The Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) is an international collaborative project with the overall objective of standardizing the approach to the evaluation and treatment of critically ill patients world-wide, in accordance with best-practice principles. A simulation study by the same group further suggests that checklists significantly improve surgical care during emergency situations where rapid and correct decisionmaking is crucial to ensure good patient outcomes [4]. Building upon these experiences and advances in informatics and human factor engineering, a novel electronic tool, the Checklist for Early Recognition and Treatment of Acute Illness and Injury (CERTAIN), is being developed by a large international collaboration with the overall objective of standardizing the approach world-wide to the evaluation and treatment of critically ill patients, in accordance with best-practice principles [5]. CERTAIN may be beneficial in low-resource settings with a scarcity of formally trained personnel [6]
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