Use of clinical decision tools across urgent and primary care: recognising barriers and challenges

Background: Clinical decision tools (CDTs) are widely used in medical and advanced practice roles to support decision making and stratify clinical outcomes. While many CDTs are included in national guidelines, substantial evidence suggests that they are not used appropriately to guide clinical decision making in practice. Aims: To understand the barriers and challenges to clinicians using CDTs in urgent care and primary care settings. Methods: The STARLITE framework for conducting systematic literature reviews was used. A total of 11 articles were included in this review, which used a mixed-methods approach, and were critically analysed to identify emerging themes. Findings: Three distinct themes emerged as barriers to the use of CDTs in urgent and primary care settings: time constraints, perceived benefit and alarm fatigue. Conclusions: This literature review highlights that compliance with CDTs is a multifaceted issue. Clinicians should be informed about the evidence base and benefits of CDTs, especially given their integration into national and local clinical guidelines. Moreover, further research must be conducted into useability, integration into IT systems and the impact of alarm fatigue, which is identified as a potential threat to patient safety.