Intelligent Clinical Decision Support for Preoperative Blood Management: A Cluster-Randomized Clinical Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Frequency of patients with a type and screen order placed during the preoperative clinic assessment visit
研究概览
简要总结
20 million patients have surgery in the United States every year, with approximately 1 million of those patients requiring life-saving blood transfusion. Presurgical preparation for transfusion is important to allow for safe and timely transfusion during surgery; however, excessive preparation is unfortunately common, costly, and contributes to blood waste. This study aims to evaluate an intelligent clinical decision support system that helps clinicians prepare blood for patients who are likely to need it, while avoiding excessive preparation for patients who don't, potentially improving patient safety while reducing blood waste and healthcare costs.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Screening
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinician Level
排除标准
- •Clinician (resident physician or advanced practice provider) who works at a preoperative assessment clinic
- •Clinician Level Exclusion Criteria:
- •Patient Inclusion Criteria:
- •Scheduled for surgery in one of the main operating room areas (non-remote) at Barnes Jewish Hospital
- •Evaluated in-person at one of the preoperative assessment clinics affiliated with BJC Healthcare
- •Have a valid S-PATH model prediction prior to their preoperative assessment clinic visit
- •Patient Exclusion Criteria:
- •Presence or history of red cell alloantibodies
研究组 & 干预措施
S-PATH
Access to the S-PATH clinical decision support system
干预措施: S-PATH clinical decision support system (Other)
Usual care
Usual care for determining presurgical blood orders, including use of the institutional Maximum Surgical Blood Ordering Schedule (MSBOS)
干预措施: Usual care (Other)
结局指标
主要结局
Frequency of patients with a type and screen order placed during the preoperative clinic assessment visit
时间窗: Decision made during the preoperative assessment clinic visit
This is a binary outcome at the patient / surgical case level, which will be aggregated across all patients in the study to produce an overall frequency. Placement of a type and screen order during the preoperative clinic assessment visit will be evaluated at the patient / surgical case level. This includes orders placed and collected during the preoperative clinic assessment visit, as well as orders signed during the preoperative clinic assessment visit or subsequent follow up care and held to be drawn on the day of surgery.
次要结局
- Red cell transfusion during surgery where the preoperative clinic clinician did not order the type and screen but a subsequent clinician did(Day of surgery)
- Frequency of a valid type and screen order at the start of surgery(Start of surgery (1 hour after Anesthesia Start))
- Frequency of red cell transfusion during surgery(During surgery)
- Frequency of emergency release blood use during surgery(During surgery)
- Frequency of red cell transfusion during surgery without an active type and screen at the start of surgery(During surgery)
- Frequency of transfusion reaction(From time of surgery to hospital discharge or 30 days after surgery)
研究者
Sunny Lou
Assistant Professor
Washington University School of Medicine