Table 5 Quotes about experiences using the CDSS (advantages and challenges)

1.

Overall, I think it is useful (resident physician)

2.

For me the outline of the process for the Decubitus was valuable. (senior consultant)

3.

The overview as a sort of checklist was good (junior physician)

4.

I thought it was like guidelines. You were reminded whether it is time to change something – I asked myself the questions: is it correct, can we do this now? It is like following a standard process (nurse expert)

5.

You don’t necessarily have to do it then; you can also reset or change it. (nurse expert)

6.

When the tool was presented, I was very optimistic. I had the feeling this could be very interesting, especially knowing what phase the patient is in or what the physio is doing and what ergotherapy is he receiving? (nurse expert)

7.

It is extremely confusing. I continue to read the processes from Medfolio. The PMC is very unclear. (junior physician)

8

On the one hand a ton of potential, also for handovers between different steps, on the other hand a huge risk to get lost in detail. (therapy expert)

9.

I think this may be the biggest issue, it is too detailed (senior consultant)

10.

Filling in the required information in the system took up more time than we saved through the process, this is a complete no-go. (senior consultant)

11.

For me the accessibility and speed of our IT system are completely useless. (senior consultant)

12.

In the end things did not work as we planned. For example, logging into the system did not always work. (nurse expert)

13.

You need to look for the patient, then you have to click management, then you need to go somewhere else [in the system] … somehow there is no overview (resident physician)

14.

You always have to take the extra step to open it. It does not automatically open to remind you that something is still red. You actively have to open it (junior physician)

15.

Doing this twice, or rather duplication is definitely a big topic for our IT-system. It would be great if we could get rid of this, e.g. by things populating automatically once the information is filled in in one location. (nurse expert)

16.

And then, it does not autocomplete, you need to activate and confirm it. It does not simply happen once you entered the information. (nurse expert)

17.

The main issue was that it is various systems in which we work. (senior consultant)

18.

Since we work in so many different programs it eats up your time to work according to this process. (junior physician)

19.

I want to work scientifically. Instead of the system getting the required information itself, you need to go from one section to another to get the data yourself. In the end you feel like Sisiphus. (senior consultant)

20.

One did not really look at the system. It was simply used for the others, so they could draw conclusions. (nurse expert)

21.

I would claim you have also witnessed it when you substituted me. The regular employee did not do anything with the system. It was only the team-leader when he visited the patient, not the regular employee who is actually affected, who used the system. The regular employee had no clue. (therapy expert)

22.

I have the impression that in this process we want to collect data, as you said, and want to analyze and use it for research. (junior physician)

23.

After a while we noticed that other departments or also we forgot to enter the information. Things are just done so automatically. One is caught up in old behavior patterns. (nurse expert)

24.

It just takes longer but the quality is not better. (therapy expert)

25.

It was simply completing a task. It did not help us in our clinical day to day work, it was simply an externally imposed duty. (therapy expert)