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

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00952471
First Posted: August 6, 2009
Last Update Posted: May 21, 2015
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Collaborator:
Siemens Medical
Information provided by (Responsible Party):
Brian Jacobs, Children's Research Institute
  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
Intervention Model: Factorial Assignment
Masking: None (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

Further study details as provided by Brian Jacobs, 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 ]

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.
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

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
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
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00952471


Locations
United States, Ohio
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States, 45229
Sponsors and Collaborators
Brian Jacobs
Siemens Medical
  More Information

Responsible Party: Brian Jacobs, MD, Children's Research Institute
ClinicalTrials.gov Identifier: NCT00952471     History of Changes
Other Study ID Numbers: 05-11-34
First Submitted: July 24, 2009
First Posted: August 6, 2009
Last Update Posted: May 21, 2015
Last Verified: May 2015

Keywords provided by Brian Jacobs, Children's Research Institute:
Asthma
Children
CPOE
Decision Support
Framing
Heuristic
Order Sets