Development of an Educational Strategy and Decision Support Tool to Enhance Appropriate Use of Stress Echocardiography at a Large Academic Medical Center: A Prospective, Pre- and Postintervention Analysis

2015 ◽  
Vol 28 (12) ◽  
pp. 1401-1409 ◽  
Author(s):  
Kevin Levitt ◽  
Jeremy Edwards ◽  
Chi-Ming Chow ◽  
R. Sacha Bhatia
Keyword(s):  
Decision Support ◽  
Stress Echocardiography ◽  
Medical Center ◽  
Academic Medical Center ◽  
Decision Support Tool ◽  
Educational Strategy ◽  
Appropriate Use ◽  
Support Tool ◽  
Academic Medical

scholarly journals APPROPRIATE USE OF STRESS ECHOCARDIOGRAPHY AT AN ACADEMIC MEDICAL CENTER IN A PUBLIC FUNDED HEALTHCARE SYSTEM

2014 ◽  
Vol 63 (12) ◽  
pp. A1233
Author(s):  
Kevin Levitt ◽  
Jeremy Edwards ◽  
Chi-Ming Chow ◽  
Howard Leong-Poi ◽  
Zakariya Albinmousa ◽  
...  
Keyword(s):  
Healthcare System ◽  
Stress Echocardiography ◽  
Medical Center ◽  
Academic Medical Center ◽  
Appropriate Use ◽  
Academic Medical

Uptake and impact of a clinical diagnostic decision support tool at an academic medical center

Diagnosis ◽  
2015 ◽  
Vol 2 (2) ◽  
pp. 123-127 ◽  
Author(s):  
John S. Barbieri ◽  
Benjamin French ◽  
Craig A. Umscheid
Keyword(s):  
Mobile Devices ◽  
Healthcare System ◽  
Medical Center ◽  
Academic Medical Center ◽  
Decision Support Tool ◽  
Support Tool ◽  
Academic Medical ◽  
Diagnostic Decision ◽  
The Impact ◽  
Related Harm

AbstractUse of differential diagnosis (DDX) generators may reduce the incidence of misdiagnosis-related harm, but there is a paucity of research examining the use and impact of such systems in real-world settings.In September 2012, the DDX generator VisualDx was made available across our entire academic healthcare system. We examined the use of VisualDx by month for the 18 months following its introduction. In addition, we compared the number of inpatient dermatology consults requested per month at the flagship hospital of our healthcare system for the 12 months before versus 18 months after VisualDx introduction.Across our entire academic healthcare system, there were a median of 474 (interquartile range 390–544) unique VisualDx sessions per month. VisualDx was accessed most frequently through mobile devices (35%) and the inpatient electronic health record (34%). Prior to VisualDx introduction, there was a non-significant increase in the number of inpatient dermatology consultations requested per month at the flagship hospital of our healthcare system (1.0 per month, 95% CI –2.5–4.6, p=0.54), which remained 1.0 consults per month (95% CI –0.9–2.9, p=0.27) following its introduction (p=0.99 comparing post- versus pre-introduction rates).The DDX generator VisualDx was regularly used, primarily on mobile devices and inpatient workstations, and was not associated with a change in inpatient dermatology consultation requests. Given the interest in DDX generators, it will be important to evaluate further the impact of such tools on the quality and value of care delivered.

scholarly journals Integrated clinical decision support : assessing opportunities and outcomes

2019 ◽  
Author(s):  
◽  
Timothy A. Green
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Medical Center ◽  
Academic Medical Center ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Perceived Usefulness ◽  
Inpatient Setting ◽  
Support Tool ◽  
Novel Approach

Medical calculators play an important role as a component of specific clinical decision support (CDS) systems that synthesize measurable evidence and can introduce new medical guidelines and standards. Understanding the features of calculators is important for calculator adoption and clinical acceptance. Some medical calculators can fulfill the role of CDS for Meaningful Use purposes. However, there are barriers for clinicians to use medical calculators in practice. This research presents a novel classification system for medical calculators and explores clinician use and perceived usefulness of medical calculators. Additionally, we examine the effects of an EHR integrated decision support tool on management of pain in an inpatient setting. Metadata on 766 medical calculators implemented online were collected, analyzed, and categorized by their input types, method of presenting results, and advisory nature of those results. Reference rate, publication year, and availability of references were collected. We surveyed a population of resident and attending physicians at a medium-sized academic medical center to discover the prevalence of medical calculator use, how they were accessed, and what factors might influence their use, for example, EMR integration. We also conducted a retrospective evaluation of an EHR integrated CDS module focused on pain management, leveraging a novel approach to digital workflow evaluation within the EHR, focusing on patient-centric outcome measurements.

scholarly journals Appropriate use criteria adoption for PCI at an academic medical center

2018 ◽  
Vol 39 (47) ◽  
pp. 4136-4138
Author(s):  
Ahmad Younes ◽  
Jennifer S Hoff ◽  
Alexandria M Bojansky ◽  
Ankur Kalra
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Appropriate Use Criteria ◽  
Appropriate Use ◽  
Academic Medical

Test stewardship, frequency and fidelity: Impact on reported hospital-onset Clostridioides difficile

2019 ◽  
Vol 40 (6) ◽  
pp. 710-712 ◽  
Author(s):  
Michele S. Fleming ◽  
Olivia Hess ◽  
Heather L. Albert ◽  
Emily Styslinger ◽  
Michelle Doll ◽  
...  
Keyword(s):  
Decision Support ◽  
Medical Record ◽  
Critical Review ◽  
Medical Center ◽  
Academic Medical Center ◽  
Clostridioides Difficile ◽  
Testing Frequency ◽  
Academic Medical ◽  
Support Matrix ◽  
The Impact

AbstractWe assessed the impact of an embedded electronic medical record decision-support matrix (Cerner software system) for the reduction of hospital-onset Clostridioides difficile. A critical review of 3,124 patients highlighted excessive testing frequency in an academic medical center and demonstrated the impact of decision support following a testing fidelity algorithm.

scholarly journals Impact of clinical decision support therapeutic interchanges on hospital discharge medication omissions and duplications

2021 ◽  
Author(s):  
Erin Maxwell ◽  
James Amerine ◽  
Glenda Carlton ◽  
Jennifer L Cruz ◽  
Ashley L Pappas ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Medication Reconciliation ◽  
Medical Center ◽  
Academic Medical Center ◽  
Clinical Decision ◽  
Discharge Medication ◽  
Academic Medical ◽  
Before And After ◽  
The Impact

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Automatic therapeutic substitution (ATS) protocols are formulary tools that allow for provider-selected interchange from a nonformulary preadmission medication to a formulary equivalent. Previous studies have demonstrated that the application of clinical decision support (CDS) tools to ATS can decrease ATS errors at admission, but there are limited data describing the impact of CDS on discharge errors. The objective of this study was to describe the impact of CDS-supported interchanges on discharge prescription duplications or omissions. Methods This was a single-center, retrospective cohort study conducted at an academic medical center. Patients admitted between June 2017 and August 2019 were included if they were 18 years or older at admission, underwent an ATS protocol–approved interchange for 1 of the 9 included medication classes, and had a completed discharge medication reconciliation. The primary outcome was difference in incidence of therapeutic duplication or omission at discharge between the periods before and after CDS implementation. Results A total of 737 preimplementation encounters and 733 postimplementation encounters were included. CDS did not significantly decrease the incidence of discharge duplications or omissions (12.1% vs 11.2%; 95% confidence interval [CI], –2.3% to 4.2%) nor the incidence of admission duplication or inappropriate reconciliation (21.4% vs 20.7%; 95% CI, –3.4% to 4.8%) when comparing the pre- and postimplementation periods. Inappropriate reconciliation was the primary cause of discharge medication errors for both groups. Conclusion CDS implementation was not associated with a decrease in discharge omissions, duplications, or inappropriate reconciliation. Findings highlight the need for thoughtful medication reconciliation at the point of discharge.

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