| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Melnick, Edward R. Genes, Nicholas G. Chawla, Neal K. Akerman, Meredith Baumlin, Kevin M. Jagoda, Andy |
| Abstract | Aims To influence physician practice behavior after implementation of a computerized clinical decision support system (CDSS) based upon the recommendations from the 2007 ACEP Clinical Policy on Syncope. Methods This was a pre-post intervention with a prospective cohort and retrospective controls. We conducted a medical chart review of consecutive adult patients with syncope. A computerized CDSS prompting physicians to explain their decision-making regarding imaging and admission in syncope patients based upon ACEP Clinical Policy recommendations was embedded into the emergency department information system (EDIS). The medical records of 410 consecutive adult patients presenting with syncope were reviewed prior to implementation, and 301 records were reviewed after implementation. Primary outcomes were physician practice behavior demonstrated by admission rate and rate of head computed tomography (CT) imaging before and after implementation. Results There was a significant difference in admission rate pre- and post-intervention (68.1% vs. 60.5% respectively, p = 0.036). There was no significant difference in the head CT imaging rate pre- and post-intervention (39.8% vs. 43.2%, p = 0.358). There were seven physicians who saw ten or more patients during the pre- and post-intervention. Subset analysis of these seven physicians’ practice behavior revealed a slight significant difference in the admission rate pre- and post-intervention (74.3% vs. 63.9%, p = 0.0495) and no significant difference in the head CT scan rate pre- and post-intervention (42.9% vs. 45.4%, p = 0.660). Conclusions The introduction of an evidence-based CDSS based upon ACEP Clinical Policy recommendations on syncope correlated with a change in physician practice behavior in an urban academic emergency department. This change suggests emergency medicine clinical practice guideline recommendations can be incorporated into the physician workflow of an EDIS to enhance the quality of practice. |
| Related Links | https://intjem.biomedcentral.com/counter/pdf/10.1007/s12245-010-0168-x.pdf |
| Ending Page | 104 |
| Page Count | 8 |
| Starting Page | 97 |
| File Format | HTM / HTML |
| ISSN | 18651380 |
| DOI | 10.1007/s12245-010-0168-x |
| Journal | International Journal of Emergency Medicine |
| Issue Number | 2 |
| Volume Number | 3 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2010-06-01 |
| Access Restriction | Open |
| Subject Keyword | Emergency Medicine Internal Medicine Cardiology Angiology Pediatrics Informatics Clinical decision support systems Practice guidelines Knowledge translation Syncope |
| Content Type | Text |
| Resource Type | Article |
| Subject | Emergency Medicine |
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