A framework for quality improvement and evaluation of a clinical decision support system in NICU environment in cross-cultural settings.

Abstract

The primary purpose of this quality improvement research is to design a structured study to improve clinical process and outcomes in healthcare. This thesis presents a framework for quality improvement and evaluation of a clinical decision support system in cross-cultural settings. The framework extends a SPO model to a SPOE model, combines with the CRISP-DM model and the Patient Journey Model Architecture (PaJMa); with the purpose of providing a new approach for quality improvement in a NICU environment and evaluating the effectiveness of the CDSS which was implemented as a tool to support the quality improvement research. The approach is extending mining of physiological data in real-time to develop a new clinical practice model that can be used to improve the process of caring, provide patient-central care, support clinical decision- making, and increase efficacy in acute care settings. This thesis demonstrates the framework within the neonatal care units through a case study of late onset neonatal sepsis in Canada and China, uses the CRISP-DM for the process mining and PaJMa for presentation of routine clinical practice and clinical process improvement. This research is extending McGregor’s research “A process mining driven framework for clinical guideline improvement in critical care” in 2011.