Reduction in Clinical Variance Using Targeted Design Changes in Computerized Provider Order Entry Order (CPOE) Sets - Full Text View

Sponsor:	Children's Research Institute
Collaborator:	Siemens Medical
Information provided by:	Children's Research Institute
ClinicalTrials.gov Identifier:	NCT00952471

Purpose

Selective redesign of order sets using different ways to frame the order and physician decision-making in a computerized provider order entry system could increase adherence to evidence-based care and reduce population-specific variance.

Condition	Intervention	Phase
Asthma Exacerbation	Other: Evidence Based Intervention to order set	Phase III

Study Type:	Interventional
Study Design:	Health Services Research, Non-Randomized, Open Label, Historical Control, Factorial Assignment, Efficacy Study
Official Title:	Reduction in Clinical Variance Using Targeted Design Changes in Computerized Provider Order Entry Order (CPOE) Sets

Resource links provided by NLM:

MedlinePlus related topics: Asthma

U.S. FDA Resources

Further study details as provided by Children's Research Institute:

Primary Outcome Measures:

Reduced variation from in evidence-based care through integrating evidence into the clinician workflow in the EMR system. [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Enrollment:	458
Study Start Date:	September 2004
Study Completion Date:	December 2006
Primary Completion Date:	December 2006 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Baseline Period: No Intervention Patients in the baseline period were cared for using the standard historical electronic order set.	Other: Evidence Based Intervention to order set The order set was altered to include evidence based care items
Post Intervention Period: Active Comparator Patients in the Post intervention period were cared for with evidence-bsed modified order set changes	Other: Evidence Based Intervention to order set The order set was altered to include evidence based care items

Detailed Description:

Variance in ordering of care can be characterized as the lack of uniform use of specific treatments by clinicians for a given medical condition. Unwarranted variance in healthcare has been associated with prolonged length of stay, diminished health and increased cost. Practice variation in the management of asthma can be significant and few investigators have evaluated strategies to reduce this variation. We hypothesized that selective redesign of order sets using different ways to frame the order and physician decision-making in a computerized provider order entry system could increase adherence to evidence-based care and reduce population-specific variance.

Eligibility

Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

All patients admitted using an acute asthma exacerbation order set.

Exclusion Criteria:

Patients who did not have either an admission or discharge diagnosis of asthma exacerbation.
In addition, patients admitted to the intensive care unit directly or transferred to the intensive care unit within 24-hours were excluded from analysis.
Finally, patients were excluded from analysis if asthma was not the presenting problem.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00952471

Locations

United States, Ohio
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States, 45229

Sponsors and Collaborators

Children's Research Institute

Siemens Medical

More Information

No publications provided

Responsible Party:	Children's National Medical Center, Washington, DC ( Brian Jacobs, MD )
Study ID Numbers:	05-11-34
Study First Received:	July 24, 2009
Last Updated:	August 4, 2009
ClinicalTrials.gov Identifier:	NCT00952471 History of Changes
Health Authority:	United States: Institutional Review Board

Keywords provided by Children's Research Institute:

Asthma
Children
CPOE
Decision Support

Framing
Heuristic
Order Sets

Additional relevant MeSH terms:

Hypersensitivity
Lung Diseases, Obstructive
Immune System Diseases
Respiratory Tract Diseases
Bronchial Diseases

Lung Diseases
Hypersensitivity, Immediate
Asthma
Respiratory Hypersensitivity

ClinicalTrials.gov processed this record on February 08, 2010