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Leveraging an EHR tool to improve provider adherence to the modified brain injury guidelines
Aricia Shen1, Dana Lemke1, Matthew Bloom1
1Cedars-Sinai Medical Center, Los Angeles, CA, United states.
Introduction:
The aim was to leverage electronic health record (EHR) smartphrases to improve compliance with the modified Brain Injury Guidelines (mBIG).
Methods:
Smartphrases were developed for the trauma team and radiology and implemented December 2022. Traumatic brain injury (TBI) patients meeting mBIG inclusion from 03/2021- 07/2023 were reviewed. Smartphrase usage and clinical compliance with mBIG (measured by percent reduction of repeat head imaging, ICU admissions, and neurosurgery consults) were compared pre- and post-intervention.
Results:
268 cases were examined. Post-intervention, mBIG1 patients had significantly fewer neurosurgery consults (82.4 % vs. 50.0 %, OR = 0.21, p = 0.03), while mBIG2 patients had significantly fewer repeat head CTs (91.0 % vs. 66.7 %, OR = 0.2, p = 0.01), ICU admissions (66.7 % vs. 38.5 %, OR = 0.31, p = 0.02) and neurosurgery consults (93.9 % vs. 56.4 %, OR = 0.08, p < 0.01).
Conclusion:
Standardized smartphrases can streamline workflow and significantly improve trauma team compliance with best practice guidelines for TBI and reduce unnecessary imaging, consults, and costly ICU admissions.
