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Indication-based clinical decision support for inpatient urine testing: impacts on utilization, appropriateness, and
Mario Luis Valdez Imbert1, Allyson Larcena Tipgos1, Majd Alsoubani1
1Infectious Diseases, Tufts Medical Center, Boston, USA.
Abstract:
Across a healthcare system, an indication-based clinical decision support (CDS) tool for inpatient urine testing immediately reduced urinalysis-with-reflex-to-culture (-62.7/1,000 patient-days) and urine culture ordering, while increasing urinalysis utilization(41.4/1,000 patient-days). Intervention effect was not fully sustained. Ordering appropriateness remained low, and antibiotics were often prescribed without documented symptoms, suggesting CDS alone is insufficient.
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