Effectiveness of a standardized electronic admission order set for acute exacerbation of chronic obstructive pulmonary disease

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dc.contributor.authorPendharkar, Sachin R.
dc.contributor.authorOspina, Maria B.
dc.contributor.authorGadotti, D. A.
dc.contributor.authorHirani, Naushad
dc.contributor.authorGraham, Jim Allen
dc.contributor.authorFaris, Peter D.
dc.contributor.authorBhutani, Mohit
dc.contributor.authorLeigh, Richard A.
dc.contributor.authorMody, Christopher H.
dc.contributor.authorStrickland, Michael K.
dc.date.accessioned2018-06-13T14:30:23Z
dc.date.available2018-06-13T14:30:23Z
dc.date.issued2018-05-30
dc.description.abstractBackground: Variation in hospital management of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) may prolong length of stay, increasing the risk of hospital-acquired complications and worsening quality of life. We sought to determine whether an evidence-based computerized AECOPD admission order set could improve quality and reduce length of stay. Methods: The order set was designed by a provincial COPD working group and implemented voluntarily among three physician groups in a Canadian tertiary-care teaching hospital. The primary outcome was length of stay for patients admitted during order set implementation period, compared to the previous 12 months. Secondary outcomes included length of stay of patients admitted with and without order set after implementation, all-cause readmissions, and emergency department visits. Results: There were 556 admissions prior to and 857 admissions after order set implementation, for which the order set was used in 47%. There was no difference in overall length of stay after implementation (median 6.37 days (95% confidence interval 5.94, 6.81) pre-implementation vs. 6.02 days (95% confidence interval 5.59, 6.46) post-implementation, p = 0.26). In the post-implementation period, order set use was associated with a 1.15-day reduction in length of stay (95% confidence interval − 0.5, − 1.81, p = 0.001) compared to patients admitted without the order set. There was no difference in readmissions. Conclusions: Use of a computerized guidelines-based admission order set for COPD exacerbations reduced hospital length of stay without increasing readmissions. Interventions to increase order set use could lead to greater improvements in length of stay and quality of care. Keywords: Length of stay, Clinical decision support, Chronic obstructive pulmonary disease, Quality improvementen_US
dc.description.grantingagencyAlberta Health Services - Research Granten_US
dc.description.sponsorshipSponsored by the Open Access Authors Funden_US
dc.identifier.citationPendharkar, S. R., Ospina, M. B., Southern, D. A., Hirani, N., Graham, J., Faris, P., … Stickland, M. K. (2018). Effectiveness of a standardized electronic admission order set for acute exacerbation of chronic obstructive pulmonary disease. BMC Pulmonary Medicine, 18, 93. http://doi.org/10.1186/s12890-018-0657-xen_US
dc.identifier.doihttps://doi.org/10.1186/s12890-018-0657-xen_US
dc.identifier.issn1471-2466
dc.identifier.urihttp://hdl.handle.net/1880/106759
dc.identifier.urihttps://doi.org/10.11575/PRISM/43857
dc.language.isoenen_US
dc.publisherBMC Pulmonary Medicineen_US
dc.publisher.departmentCommunity Health Sciencesen_US
dc.publisher.departmentMedicineen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.hasversionPublisher's versionen_US
dc.publisher.institutionUniversity of Calgaryen_US
dc.publisher.policyhttps://www.biomedcentral.com/getpublished/copyright-and-licenseen_US
dc.rightsUnless otherwise indicated, this material is protected by copyright and has been made available with authorization from the copyright owner. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.subjectLength of stayen_US
dc.subjectClinical decision supporten_US
dc.subjectChronic obstructive pulmonary diseaseen_US
dc.subjectQuality improvementen_US
dc.titleEffectiveness of a standardized electronic admission order set for acute exacerbation of chronic obstructive pulmonary diseaseen_US
dc.typejournal articleen_US
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