Infectious Diseases Consultations as Markers of Hospital Workflow and Care Complexity

Area of Science:

• Infectious Diseases
• Health Services Research
• Clinical Informatics

Background:

• Preliminary single-centre study evaluating infectious diseases consultation (IDC) patterns.
• Assessing IDC as an indicator of hospital workflow and care complexity.
• Identifying variables for organizational research and EHR-based clinical decision support.

Purpose of the Study:

• Characterize IDC patterns in a large patient cohort.
• Analyze factors influencing hospital workflow and care complexity.
• Inform development of electronic health record (EHR)-based clinical decision support.

Main Methods:

• Retrospective analysis of 39,275 IDC requests from 16,430 patients.
• Exclusion of pediatric and specialized immunosuppressed patient units.
• Multivariable logistic regression models to assess factors associated with in-hospital mortality.

Main Results:

• Most requests originated from surgical clinics (43.8%) and ICUs (37.6%).
• Pneumonia (30.5%) was the most common indication, followed by unspecified infections (25.4%).
• Age and ICU consultation independently associated with mortality; consultation access time and COVID-19 showed block-specific associations.

Conclusions:

• IDC patterns reflect diagnostic demand, case severity, and hospital context.
• Findings support integrating clinical, organizational, and contextual variables in future research.
• Highlights need for prospective, multi-centre studies for EHR decision-support model validation.