The reasons for finding no improvements in the second hospital where CDSS was implemented can be discussed as follows:
1. Challenges in integrating the system in the hospital if there were inadequate support staff and demands more time from the already overworked staff.
2. The staff would not have received adequate training in the use of CDSS leading to errors.
3. Lack of interest shown by the clinicians as the system involves additional input processes.
4. Incorrect or incomplete data being used.
5. Absence of uniform implementation of the system throughout the organisation.
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