Evaluations of CDS Systems

Not Applicable

Not yet recruiting

• Conditions: Safety Issues
• Interventions: Other: Clinical Decision Support

• Registration Number: NCT06330740
• Lead Sponsor: New York Presbyterian Hospital

Brief Summary

Indications-based prescribing is a medication ordering system in which a clinician selects an indication, and then the electronic health record (EHR) suggests an appropriate medication regimen. This approach was shown to significantly decrease medication ordering errors in a prototype environment. However, the effect of indications-based prescribing on preventing ordering errors has not been rigorously evaluated in a real-world healthcare setting. Antibiotics are the medication class most likely to contain ordering errors, which can lead to significant patient harm. At NewYork-Presbyterian (NYP) a robust antimicrobial indication-based order set was developed to help clinicians identify the appropriate antibiotic, dose, frequency, and duration, based on type of infection and patient-specific characteristics, but it is not widely used. The investigators propose a randomized controlled trial to assess the effectiveness of this indications-based order set for reducing antimicrobial ordering errors.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-12-28
• Status Verified: 2024-03
• Study Start: 2024-03
• Study First Submitted QC: 2024-03-19
• Last Update Submitted: 2024-03-19
• Study First Posted: 2024-03-26
• Last Update Posted: 2024-03-26
• Primary Completion: 2025-09
• Study Completion: 2025-12

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 2000

Inclusion Criteria

All providers placing inpatient orders on adult patients.

Exclusion Criteria

Providers placing orders on patients who were ordered for antibiotics >24 hours in the past 72 hours and/or patients with positive cultures during that admission, and/or placing an order from the order set.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention Arm	Clinical Decision Support	-

Primary Outcome Measures

Name	Time	Method
The combined rate of Wrong Drug, Wrong Duration, Wrong Dose and Wrong Frequency Retract-And-Reorder (RAR) events will be combined to create an overall rate of near-miss ordering errors in the control and intervention arm.	Up to 18 months	Novel Health IT measures which utilize provider ordering patterns to capture near-miss ordering errors.