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Sustained impact of electronic alerts on rate of prophylaxis against venous thromboembolism.
MedLine Citation:
PMID:  21800010     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Advanced electronic alerts (eAlerts) and computerised physician order entry (CPOE) increase adequate thromboprophylaxis orders among hospitalised medical patients. It remains unclear whether eAlerts maintain their efficacy over time, after withdrawal of continuing medical education (CME) on eAlerts and on thromboprophylaxis indications from the study staff. We analysed 5,317 hospital cases from the University Hospital Zurich during 2006-2009: 1,854 cases from a medical ward with eAlerts (interventiongroup) and 3,463 cases from a surgical ward without eAlerts (controlgroup). In the intervention group, an eAlert with hospital-specific VTE prevention guidelines was issued in the electronic patient chart 6hours after admission if no pharmacological or mechanical thromboprophylaxis had been ordered. Data were analysed for three phases: pre-implementation (phase 1), eAlert implementation with CME (phase 2), and post-implementation without CME (phase3). The rates of thromboprophylaxis in the intervention group were 43.4% in phase 1 and 66.7% in phase 2 (p<0.001), and increased further to 73.6% in phase3 (p=0.011). Early thromboprophylaxis orders within 12 hours after admission were more often placed in phase 2 and 3 as compared to phase 1 (67.1% vs. 52.1%, p<0.001). In the surgical control group, the thromboprophylaxis rates in the three phases were 88.6%, 90.7%, 90.6% (p=0.16). Advanced eAlerts may provide sustained efficacy over time, with stable rates of thromboprophylaxis orders among hospitalised medical patients.
Authors:
P E Beeler; N Kucher; J Blaser
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-28
Journal Detail:
Title:  Thrombosis and haemostasis     Volume:  106     ISSN:  0340-6245     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7608063     Medline TA:  Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Prof. Dr. Jürg Blaser, Forschungszentrum Medizininformatik, Direktion Forschung und Lehre, UniversitätsSpital Zürich, Sonneggstr. 6, D5, CH-8091 Zürich, Switzerland, Tel.: +41 44 255 3618, Fax: +41 44 634 5503, E-mail: Juerg.Blaser@usz.ch.
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