Clinicians and hospital administrators are increasingly challenged to achieve efficient evidence-based care. Clinical decision support (CDS) tools are being introduced into the clinical setting to facilitate the bridging of knowledge gaps at the point of care. Order sets are one of the tools used to facilitate this knowledge translation. Using the realist review methodology and a focus group of interview participants, this thesis explored retrospectively some of the causal relationships that lead to effective and successful order set adoption. Findings demonstrate the need for in-depth and regular review of context and order set adoption. Technology can offer some enhancements in the form of delivery tools, but it also introduces new and complex challenges for development and implementation. Ongoing software development is needed to improve delivery formats as well as incorporate effective tools to allow for efficient continuous quality improvement supports. / Graduate / 0769 / 0566 / hallsm.77@gmail.com