BACKGROUND Clinical pathways (CPs) increase in popularity and are known to lead to several benefits in the hospital environment. Clinical pathways can be either paper-based or software-based. It is known that paper-based CPs can result in more paperwork instead of simplifying daily routines of healthcare workers. Insufficient research has been done on the acceptance of software-based CPs by different user groups. Our aim in this study was to assess the effectiveness of the software-based CPs (CPS) from the perspective of healthcare professionals in the hospital environment as well as to investigate the differences in perceived effectiveness between user groups. METHODS Using surveys and interviews, data were collected in four departments of an academic medical center. A distinction was made between decision makers (DM) and executive staff (ES). The surveys contained questions based on the Technology Acceptance Model and four objectives of the software defined by the hospital. Statistical tests were used to investigate the effectiveness of CPS and study the differences between DM and ES. Interviews were recorded and transcribed based on grounded theory principals. RESULTS After implementation, monitoring protocol-based working was significantly improved (p = .026) and significantly higher efficiency on the work floor was reported (p = .046). ES perceived the software as less useful than expected (Md = 3.25 vs. Md = 2.75, p = .028) compared to DM and were less convinced of its ability to improve monitoring protocol-based working. The most important benefits of CPS as perceived by its users are the better overview of tasks it provides and facilitating documentation. Negative aspects mentioned were the lack of usability and the inflexibility of the software, and particularly ES claimed that the software did not increase their effectiveness. CONCLUSION Our study showed that CPS is effective from healthcare professionals' perspective due to its ability to increase monitoring of protocol-based working and by enhancing the efficiency on the work floor. However, the users also acknowledge that the software lacks usability and is not flexible enough, which results in an additional workload. Policy makers should be more focused on informing and training executive staff more thoroughly when implementing a CPS. Our results strongly suggest that executive staff members need to be convinced of its usefulness and the added value a CPS provides. Preferably, they should be involved in the design phase of the software.

中文翻译：

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临床途径软件的感知效果：在荷兰进行的一项前后研究。

背景技术临床途径（CP）的流行度增加并且已知在医院环境中导致多种益处。临床途径可以是基于纸张的或基于软件的。众所周知，基于纸张的CP可能会导致更多的文书工作，而不是简化医护人员的日常工作。关于不同用户群体对基于软件的CP的接受程度的研究不足。我们在这项研究中的目的是从医护人员在医院环境中的角度评估基于软件的CP（CPS）的有效性，并调查用户群体之间的感知有效性差异。方法通过调查和访谈，从一个学术医学中心的四个部门收集数据。决策者（DM）和执行人员（ES）之间有所区别。调查包含基于技术验收模型和医院定义的软件四个目标的问题。统计测试用于调查CPS的有效性，并研究DM和ES之间的差异。访谈是根据扎根的理论原理进行记录和抄录的。结果实施后，基于协议协议的监视工作得到了显着改善（p = .026），据报道，在工作现场的工作效率也显着提高（p = .046）。与DM相比，ES认为该软件没有预期的有用（Md = 3.25 vs. Md = 2.75，p = .028），并且对增强基于监视协议的工作的能力不那么相信。用户认为CPS最重要的好处是可以更好地概述其提供的任务并简化文档编制工作。提到的负面方面是软件缺乏可用性和不灵活性，尤其是ES声称该软件并未提高其有效性。结论我们的研究表明，CPS从医疗保健专业人员的角度来看是有效的，这是因为CPS能够增强对基于协议的工作的监控并能够提高工作效率。但是，用户也认识到该软件缺乏可用性并且不够灵活，这导致了额外的工作量。实施CPS时，决策者应更加专注于更全面地通知和培训执行人员。我们的结果强烈表明，执行人员必须确信其有用性和CPS提供的附加价值。优选地，它们应该参与软件的设计阶段。