The Use of Non-Interruptive Alerts for Improving the Use of Clinical Decision Rules in the Emergency Department: A Cluster Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Total clinical decision rule usage
研究概览
简要总结
This study is an extension of a planned quality improvement project that aims to promote standard of care by increasing the use of evidence-based clinical decision rules amongst emergency medicine providers in the University of Utah Emergency Department. Patient-specific information from the EHR will be used to recommend the use of relevant clinical decision rules to emergency medicine providers at the point-of-care. These recommendations will be in the form of non-interruptive alerts with one-click access to the suggested decision rules through the MDCalc Connect EHR add-on application. Specific aims of the study are to determine if 1) patient-specific non-interruptive alerts increase the use of clinical decision rules amongst emergency medicine providers and 2) an increase in the use of clinical decision rules affects provider ordering habits.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 16 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Patient Inclusion Criteria:
- •16 years of age or older
- •Qualifying chief complaint*
排除标准
- •A full list of the qualifying chief complaints is provided in Appendix A of the full research protocol.
研究组 & 干预措施
Intervention Group
The intervention will contain two components: 1) a non-interruptive best practice advisory (BPA) in the Epic Storyboard and 2) a default suggested calculator tab in the MDCalc Connect app. Six clinical decision rules will be included: Canadian CT Head Rule, Canadian C-spine Rule, HEART Score, PERC Rule, Wells' PE Criteria and Wells' DVT Criteria. Predefined criteria based on chief complaint, patient age and vital signs will be used to determine when a decision rule may be relevant in a patient encounter. When a patient meets all of the predefined criteria, the intervention will be triggered.
干预措施: Clinical Decision Rule Alerts (Other)
Control Group
The control group will be usual care. Specifically, providers in the control group will not receive the clinical decision rule alert or the default suggested calculator tab in the MDCalc Connect app. The control group providers will have access to the MDCalc Connect app in its standard form and functionality.
结局指标
主要结局
Total clinical decision rule usage
时间窗: During the intervention
Composite measure of total number of clinical decision rules used through the MDCalc Connect app.
次要结局
- Admission rate(During the intervention)
- Lower extremity ultrasound(During the intervention)
- d-dimer tests(During the intervention)
- Delta troponin tests(During the intervention)
- Emergency department bounceback rate.(Up to 30 days after the intervention)
- Individual clinical decision rule usage(During the intervention)
- Computed tomography c-spine studies(During the intervention)
- Computed tomography pulmonary angiography studies(During the intervention)
- Computed tomography head studies(During the intervention)
研究者
Keaton Morgan
Postdoctoral Fellow
University of Utah