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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Atia, Jolene Evison, Felicity Gallier, Suzy Pettler, Sophie Garrick, Mark Ball, Simon Lester, Will Morton, Suzanne Coleman, Jamie Pankhurst, Tanya |
| Abstract | Background Electronic clinical decision support (CDS) within Electronic Health Records has been used to improve patient safety, including reducing unnecessary blood product transfusions. We assessed the effectiveness of CDS in controlling inappropriate red blood cell (RBC) and platelet transfusion in a large acute hospital and how speciality specific behaviours changed in response. Methods We used segmented linear regression of interrupted time series models to analyse the instantaneous and long term effect of introducing blood product electronic warnings to prescribers. We studied the impact on transfusions for patients in critical care (CC), haematology/oncology (HO) and elsewhere. Results In non-CC or HO, there was significant and sustained decrease in the numbers of RBC transfusions after introduction of alerts. In CC the alerts reduced transfusions but this was not sustained, and in HO there was no impact on RBC transfusion. For platelet transfusions outside of CC and HO, the introduction of alerts stopped a rising trend of administration of platelets above recommended targets. In CC, alerts reduced platelet transfusions, but in HO alerts had little impact on clinician prescribing. Conclusion The findings suggest that CDS can result in immediate change in user behaviour which is more obvious outside specialist settings of CC and HO. It is important that this is then sustained. In CC and HO, blood transfusion practices differ. CDS thus needs to take specific circumstances into account. In this case there are acceptable reasons to transfuse outside of these crude targets and CDS should take these into account. |
| Related Links | https://bmcmedinformdecismak.biomedcentral.com/counter/pdf/10.1186/s12911-022-02045-8.pdf |
| Ending Page | 12 |
| Page Count | 12 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14726947 |
| DOI | 10.1186/s12911-022-02045-8 |
| Journal | BMC Medical Informatics and Decision Making |
| Issue Number | 1 |
| Volume Number | 22 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2022-12-29 |
| Access Restriction | Open |
| Subject Keyword | Health Informatics Information Systems and Communication Service Management of Computing and Information Systems Red blood cells Platelets Haemoglobin Transfusion Clinical decision support CDS Electronic health records EHR e-Alerts Segmented linear regression of interrupted time series |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health Informatics Computer Science Applications Health Policy |
| Journal Impact Factor | 3.3/2023 |
| 5-Year Journal Impact Factor | 3.9/2023 |
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