Reduction in Clinical Variance Using Targeted Design Changes in Computerized Provider Order Entry Order (CPOE) Sets
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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 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Factorial Assignment Masking: Open Label Primary Purpose: Health Services Research |
| Official Title: | Reduction in Clinical Variance Using Targeted Design Changes in Computerized Provider Order Entry Order (CPOE) Sets |
- 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 |
|---|---|
|
No Intervention: Baseline Period
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
|
|
Active Comparator: Post Intervention Period
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 |
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 More Information
No publications provided
| Responsible Party: | Brian Jacobs, MD, Children's National Medical Center, Washington, DC |
| ClinicalTrials.gov Identifier: | NCT00952471 History of Changes |
| Other Study ID Numbers: | 05-11-34 |
| Study First Received: | July 24, 2009 |
| Last Updated: | August 4, 2009 |
| 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:
|
Asthma Bronchial Diseases Respiratory Tract Diseases Lung Diseases, Obstructive Lung Diseases |
Respiratory Hypersensitivity Hypersensitivity, Immediate Hypersensitivity Immune System Diseases |
ClinicalTrials.gov processed this record on May 16, 2013