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Related Experiment Videos

Improving performance with clinical decision support

D J Brailer1, S Goldfarb, M Horgan

  • 1Care Management Science Corporation, Philadelphia, USA. dbrailer@comscience.com

The Joint Commission Journal on Quality Improvement
|July 1, 1996
PubMed
Summary
This summary is machine-generated.

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Clinical and Administrative Decision-support Utility and Clinical Information System (CADU/CIS) helps identify patient care issues. This clinical decision support tool detected unnecessary fluid administration leading to congestive heart failure in intestinal obstruction patients.

Area of Science:

  • Health Informatics
  • Clinical Decision Support Systems
  • Quality Improvement in Healthcare

Background:

  • Clinical and Administrative Decision-support Utility and Clinical Information System (CADU/CIS) is a clinical decision-support workstation.
  • It facilitates timely and user-friendly analysis of large volumes of clinical information system data.
  • CADU/CIS enables the generation of customized clinical pathways for patient subgroups to identify best practice norms and compare practice variations to outcomes.

Purpose of the Study:

  • To demonstrate the utility of CADU/CIS in improving quality and reducing variations in care.
  • To highlight the role of clinical decision support in identifying and addressing clinical problems with significant implications.
  • To evaluate the impact of CADU/CIS on clinical participation in care process evaluation.

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Main Methods:

  • A multisite integrated provider utilized CADU/CIS for quality improvement initiatives.
  • A task force focused on intestinal obstruction without hernia due to high-morbidity complications.
  • A ten-step clinical performance improvement method was employed to analyze patient data.

Main Results:

  • CADU/CIS identified that unnecessary intravenous fluid administration in 104 intestinal obstruction patients led to congestive heart failure (CHF) in 5 patients.
  • The system further identified an additional 250 patients with CHF complications in one year.
  • Physicians are developing guidelines and interventions to address fluid management issues.

Conclusions:

  • Clinical decision support tools are effective in detecting clinical and economic problems.
  • These tools aid in identifying underlying causes, tracking associated tests and therapies, and monitoring interventions.
  • CADU/CIS proved instrumental in identifying and addressing a critical care issue related to fluid management.