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一个单一中心模型,用于实施SLEDAI在儿童发作的全身性红斑狼 (cSLE) 方面的文档遵守
Meghan Corrigan Nelson1,2, Colleen Mosley2, Tonya Bennett2
1Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
Lupus
|October 9, 2023
概括
改善儿科患者的系统性狼红斑血病活动指数 (SLEDAI) 文档至关重要. 临床决策支持提醒显著增加了医生坚持,克服了像遗忘和时间限制这样的障碍.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 自免疫性疾病 自免疫性疾病
- 临床信息学 临床信息学
背景情况:
- 儿童开始的全身性红斑狼 (cSLE) 是一种严重的自身免疫性疾病.
- 建议使用像SLEDAI这样的指数进行常规监测,但通常很少遵守.
- 医生遵守SLEDAI文档是学术中心的一个挑战.
研究的目的:
- 为了确定儿科SLE患者的基线SLEDAI记录率.
- 评估电子临床决策支持 (CDS) 提醒对SLEDAI文档遵守的影响.
- 为了识别SLEDAI文档的障碍.
主要方法:
- 1980年SLE在儿科学术中心24个月的遭遇的回顾.
- 实施每月的电子邮件提醒和基于EMR的CDS警报 (由anti-dsDNA结果引起).
- 持续的图表审查和每月给提供者反;干预后提供者调查.
主要成果:
- 基线的SLEDAI文档为10%.
- 每月发送的电子邮件将收费率提高到55%.
- 电子提醒进一步提高了这一比例,达到60%;忘记和缺乏时间是关键障碍.
结论:
- 每月的电子邮件提醒和EMR集成的CDS警报有效地提高了SLEDAI的文档化率.
- 解决医生报告的障碍,如遗忘和时间,对于持续的坚持至关重要.
- 改进的文档支持更好地监测和管理儿科SLE.
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