自杀性查:通过临床决策支持,确保提供者不会错过高危青少年
Shravani Vundavalli1,2, Aarti Chandawarkar1,2, Kristen Beck1
1Division of Primary Care, Nationwide Children's Hospital, Columbus, Ohio, United States.
Applied clinical informatics
|August 22, 2025
概括
这项研究改善了青少年抑郁和自杀风险查的电子健康记录警报. 加强临床决策支持确保高风险青年及时接受干预,改善患者护理.
科学领域:
- 青少年精神病学
- 临床信息学
- 公共卫生
背景情况:
- 青少年严重抑郁和自杀风险是严重的公共卫生问题.
- 有效的查和临床决策支持 (CDS) 对于及时干预至关重要.
- 利用电子健康记录 (EHR) 可以优化面临风险的年轻人的护理.
研究的目的:
- 加强青少年抑郁症和自杀风险查结果的通知系统.
- 设计和优化严重抑郁和急性死亡的CDS警报.
- 提高电子健康记录用户的知名度,减少错过的干预.
主要方法:
- 在12至20岁的患者中实施代的中断性CDS警报.
- 使用患者健康问卷 (PHQ) 和询问自杀查问题 (ASQ) 进行查.
- 根据用户反修订的警报,包括抑郁症和自杀风险的单独通知,以及时间表图标.
主要成果:
- 其中包括超过76,000次检查,随着时间的推移,检查完成率有所增加.
- 对2,355个非急性和411个急性阳性查事件发出警报.
- 警报确认率在63-96%之间,取消率在不同类型的提供者之间.
结论:
- 通过反复改进CDS警报和工作流的整合,提高了通报和可见性.
- 基于EHR的优化决策支持有效地解决了青少年的抑郁和自杀性查问题.
- 这种方法支持对高风险青年进行及时和适当的干预.
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