Co-Design in the Adaptation of a Clinical Decision Support System to Aid Violence Risk Assessment and Management: A Case Study

J Psychiatr Ment Health Nurs. 2025 Aug 21. doi: 10.1111/jpm.70023. Online ahead of print.

ABSTRACT

INTRODUCTION: The electronic application of a clinical decision support system (CDSS) conjoining the Dynamic Appraisal of Situational Aggression and the Aggression Prevention Protocol has been shown to be effective in reducing coercion and workplace violence in forensic settings in Australia. However, there is currently a lack of knowledge on the successful implementation of CDSSs across different cultural environments.

AIM: To describe the use of co-design in the adaptation of a CDSS, the eDASA+APP-FI in Finland.

METHOD: This qualitative case study followed a co-design framework involving a variety of methods, including analysing project data, rapid ethnography, and analysing the notes from co-design workshops.

RESULTS: The adaptation of the CDSS into the local context included changes to the training programme and in the frequency of use of the CDSS, as well as linguistic adjustment.

DISCUSSION: The co-design framework was valuable in identifying adaptation needs and in providing a sense of ownership among staff and consumers.

LIMITATIONS: Co-design can be time-consuming in clinical environments.

IMPLICATIONS: The results emphasise the importance of co-design in the identification of adaptation needs as part of the implementation process of a CDSS.

RECOMMENDATIONS: Co-design can be used as a framework when aiming to create a feasible CDSS.

TRIAL REGISTRATION: NCT anonymised.

PMID:40842132 | DOI:10.1111/jpm.70023