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Related Concept Videos

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Related Experiment Video

Updated: May 25, 2025

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Optimizing Wound Culture Ordering in Electronic Health Records: A Case Report.

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Improving electronic health record (EHR) ordering for wound cultures significantly reduced inappropriate tissue specimen submissions. Targeted EHR optimization enhances appropriate microbiology test ordering for wound infections.

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Area of Science:

  • Medical Laboratory Science
  • Health Informatics
  • Clinical Microbiology

Background:

  • Suboptimal electronic health record (EHR) menu design led to frequent incorrect ordering of wound cultures for tissue specimens.
  • Wound cultures were often requested for chronic wounds with low suspicion of acute infection, indicating inappropriate test utilization.

Purpose of the Study:

  • To report on specific EHR test menu design modifications aimed at improving the appropriateness of microbiology test ordering.
  • To assess the impact of EHR interface changes on wound culture and tissue culture order accuracy.

Main Methods:

  • Renamed 'Wound Culture' to 'Wound Swab Culture' and introduced 'Tissue Culture' quick orders.
  • Implemented a diagnostic questionnaire for 'Wound Swab Culture' orders to assess clinical indicators of infection (pus, erythema, surgical wound status).

Main Results:

  • Erroneous tissue specimen submissions with wound culture orders decreased from 6.6% to 0%.
  • Diagnostic questionnaire use was 27.5%; 6.1% of orders were deemed potentially inappropriate based on questionnaire responses.
  • Tissue culture orders increased (228 to 349), while wound culture orders decreased (575 to 460), indicating improved test selection.

Conclusions:

  • Targeted EHR optimization can significantly improve the accuracy of microbiology test ordering for wound infections.
  • Interface design changes and clinical decision support tools enhance appropriate test utilization in clinical microbiology.