Hardwiring diagnostic stewardship using electronic ordering restrictions for gastrointestinal pathogen testing.
Publication/Presentation Date
6-1-2019
Abstract
OBJECTIVE: To evaluate the impact of a hard stop in the electronic health record (EHR) on inappropriate gastrointestinal pathogen panel testing (GIPP).
DESIGN: We used a quasi-experimental study to evaluate testing before and after the implementation of an EHR alert to stop inappropriate GIPP ordering.
SETTING: Midwest academic medical center.
PARTICIPANTS: Hospitalized patients with diarrhea for which GIPP testing was ordered, between January 2016 through March 2017 (period 1) and April 2017 through June 2018 (period 2).
INTERVENTION: A hard stop in the EHR prevented clinicians from ordering a GIPP more than once per admission or in patients hospitalized for >72 hours.
RESULTS: During period 1, 1,587 GIPP tests were ordered over 212,212 patient days, at a rate of 7.48 per 1,000 patient days. In period 2, 1,165 GIPP tests were ordered over 222,343 patient days, at a rate of 5.24 per 1,000 patient days. The Poisson model estimated a 30% reduction in total GIPP ordering rates between the 2 periods (relative risk, 0.70; 95% confidence interval [CI], 0.63-0.78; P 72 hours.
Volume
40
Issue
6
First Page
668
Last Page
673
ISSN
1559-6834
Published In/Presented At
Marcelin, J. R., Brewer, C., Beachy, M., Lyden, E., Winterboer, T., Murphy, C. N., Fey, P. D., Hood, L., & Van Schooneveld, T. C. (2019). Hardwiring diagnostic stewardship using electronic ordering restrictions for gastrointestinal pathogen testing. Infection control and hospital epidemiology, 40(6), 668–673. https://doi.org/10.1017/ice.2019.78
Disciplines
Medicine and Health Sciences
PubMedID
31012405
Department(s)
Department of Pathology and Laboratory Medicine
Document Type
Article