临床决策支持工具的比较,以改善儿科脂质查
Amir Goren1, Henri C Santos1, Thomas W Davis2
1Behavioral Insights Team, Steele Institute for Health Innovation, Geisinger Health System, Danville, PA.
The Journal of pediatrics
|February 24, 2024
概括
电子警报显著增加了9-11岁儿童的脂质查订单和完成. 临床决策支持工具,特别是警报,提高了符合指南的查率.
科学领域:
- 儿科健康 儿科健康
- 临床决策支持系统 临床决策支持系统
- 预防性心脏病学 预防性心脏病学
背景情况:
- 在儿童中,指南推的脂质查未得到充分利用.
- 需要有效的策略来改善对查指南的遵守.
- 集成到电子健康记录 (EHR) 中的临床决策支持 (CDS) 工具显示出有希望.
研究的目的:
- 评估不同CDS工具在增加临床医生订单和患者完成儿科患者脂质查方面的有效性.
- 为了比较被动护理缺口清单与主动警报的影响,以及它们的组合,与标准实践相比.
主要方法:
- 在盖辛格健康系统内进行了一项实用性,患者随机化临床试验,涉及13,346名9至11岁的儿童.
- 四个组进行了比较:被动护理缺口列表,主动警报小组,联合护理缺口和警报,以及使用标准实践的对照组.
- 测量结果包括临床医生对脂质查的订单和患者在一周内完成测试.
主要成果:
- 活跃CDS手臂 (护理间隔和/或警报) 的患者与对照手臂相比,有显著更高的可能性要求和完成脂质查 (ORs为1.67至5.73的订单,1.54-2.90的完成).
- 有关关护理差距的清单或没有关心的活跃警报,在增加查订单方面表现优于单独的关心差距 (ORs 2.92-3.43).
结论:
- 基于电子健康记录的警报有效地增加了儿童群体的脂质查的订购和完成.
- CDS工具,特别是主动警报,可以显著改善符合指南的预防性护理.
- 在EHR中随机对待患者提供了一种可靠的方法来评估不同临床支持干预措施的比较有效性.
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