| Autor: |
Caleb J Murphy, Vanshika Narala, Aishwarya Katiki, Maylyn S Martinez, Matthew T Cerasale, Khanh T Nguyen |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
BMJ Open Quality, Vol 13, Iss 4 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2399-6641 |
| DOI: |
10.1136/bmjoq-2024-002889 |
| Popis: |
Introduction High-frequency recurring orders placed through the electronic medical record (EMR) may contribute to unnecessary care in hospitalised patients. This quality initiative sought to develop and pilot test a hospital order set for bundled review and de-implementation of common recurring orders.Methods A voluntary-use EMR order set was developed to display low-frequency order alternatives for common hospital care components. The order set was introduced to hospitalists at a large academic hospital from February to June 2023. Orders for overnight vital signs, tubes/tethers (a composite of telemetry, continuous pulse oximetry and Foley catheter) and daily labs (a composite of complete blood counts and metabolic panels) were monitored twice weekly in hospitalised patients at low risk for clinical decompensation from December 2022 through June 2023. Paired t-test was used to assess for differences in order frequency before and after order set introduction.Results The order set was used in 48 unique encounters to place 80 de-implementation orders, most commonly for discontinuation of overnight vital signs (n=37). Two or more de-implementation orders were placed during 44% of order set encounters. Mean (SD) total high-frequency orders decreased by 0.22 per patient day (95% CI −0.39 to −0.06; p=0.010) after order set introduction, driven by a reduction in overnight vital sign orders of 0.17 per patient day (95% CI −0.23 to −0.12; p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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