Feedback at the Point of Care to Decrease Medication Alert Rates in an Electronic Health Record
| Autor: | Emrah Gecili, Thomas Minich, P. J. Van Camp, S. Andrew Spooner, Judith W. Dexheimer, Eric S. Kirkendall, Philip A. Hagedorn, Michal Kouril |
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| Rok vydání: | 2019 |
| Předmět: |
Pediatric emergency
Drug-Related Side Effects and Adverse Reactions Point-of-Care Systems Reminder Systems MEDLINE Clinical decision support system Medical Order Entry Systems Feedback 03 medical and health sciences 0302 clinical medicine Salience (neuroscience) Electronic health record 030225 pediatrics Electronic Health Records Humans Medication Errors Medicine Prospective Studies Child Point of care business.industry 030208 emergency & critical care medicine General Medicine Decision Support Systems Clinical medicine.disease Pediatrics Perinatology and Child Health Emergency Medicine Feasibility Studies Medical emergency Emergency Service Hospital business |
| Zdroj: | Pediatric Emergency Care. 36:e417-e422 |
| ISSN: | 1535-1815 0749-5161 |
| DOI: | 10.1097/pec.0000000000001847 |
| Popis: | Frequently overridden alerts in the electronic health record can highlight alerts that may need revision. This method is a way of fine-tuning clinical decision support. We evaluated the feasibility of a complementary, yet different method that directly involved pediatric emergency department (PED) providers in identifying additional medication alerts that were potentially incorrect or intrusive. We then evaluated the effect subsequent resulting modifications had on alert salience. Methods We performed a prospective, interventional study over 34 months (March 6, 2014, to December 31, 2016) in the PED. We implemented a passive alert feedback mechanism by enhancing the native electronic health record functionality on alert reviews. End-users flagged potentially incorrect/bothersome alerts for review by the study's team. The alerts were updated when clinically appropriate and trends of the impact were evaluated. Results More than 200 alerts were reported from both inside and outside the PED, suggesting an intuitive approach. On average, we processed 4 reviews per week from the PED, with attending physicians as major contributors. The general trend of the impact of these changes seems favorable. Discussion The implementation of the review mechanism for user-selected alerts was intuitive and sustainable and seems to be able to detect alerts that are bothersome to the end-users. The method should be run in parallel with the traditional data-driven approach to support capturing of inaccurate alerts. Conclusions User-centered, context-specific alert feedback can be used for selecting suboptimal, interruptive medication alerts. |
| Databáze: | OpenAIRE |
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