在综合医疗保健系统中实施一套针对急性胰腺炎的电子临床决策支持订单:一种混合方法分析
Sarvanand Patel1, Bechien U Wu2,3, Tiffany Luong2
1Internal Medicine, Southern California Permanente Medical Group, Los Angeles, CA.
Pancreas
|December 26, 2025
概括
研究了针对急性胰腺炎 (AP) 的标准化订单输入系统 (OES) 和临床决策支持 (CDS) 工具. 使用与长期停留时间的减少有关,但采用仍然有限.
科学领域:
- 临床信息学 临床信息学
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 标准化订单输入系统 (OES) 和临床决策支持 (CDS) 工具可以改善基于证据的实践.
- 针对急性胰腺炎 (AP) 的OES-CDS工具旨在标准化护理.
- 使用混合方法分析来评估AP OES-CDS的使用,障碍和促进者.
研究的目的:
- 评估AP特定OES-CDS工具的采用和影响.
- 确定影响AP OES-CDS使用的障碍和促进因素.
- 评估AP OES-CDS使用与住院长度和死亡率等临床结果之间的关联.
主要方法:
- 一项回顾性队列研究,对12家医院 (2014-2022) 的16874例AP住院情况进行了研究.
- 量化分析检查了OES-CDS的采用,停留时间 (LOS) 和死亡率.
- 定性分析涉及重点小组,以探索OES-CDS的感知好处,障碍和改进建议.
主要成果:
- 年度AP OES-CDS使用率在2021年达到7.4%的峰值.
- 即使在调整后,AP OES-CDS使用与长期停留时间的减少有关 (OR:0.81,95% CI:0.69-0.94),即使在调整后.
- 在OES使用和住院死亡率之间没有发现显著的关联 (OR:0.89,95%CI:0.61-1.32).
- 障碍包括缺乏意识,竞争工具和复杂的患者病例混合.
结论:
- 观察到AP OES-CDS的采用程度有限.
- 使用AP OES-CDS工具与长期停留时间的减少相关.
- 提高提供者意识和完善工具对于在AP管理中产生更广泛影响至关重要.
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