Non-Interruptive Alerts for Improving Use of Clinical Decision Rules

Utah System of Higher Education (USHE)

Status: Completed

Conditions: Pulmonary Embolism; Minor Head Injury; Chest Pain; Deep Vein Thrombosis; Neck Trauma

Treatments: Other: Clinical Decision Rule Alerts

Study type: Interventional

Funder types: Other

Identifiers

NCT04702308

00137874

Details and patient eligibility

About

This study is an extension of a planned quality improvement project that aims to promote standard of care by increasing the use of evidence-based clinical decision rules amongst emergency medicine providers in the University of Utah Emergency Department. Patient-specific information from the EHR will be used to recommend the use of relevant clinical decision rules to emergency medicine providers at the point-of-care. These recommendations will be in the form of non-interruptive alerts with one-click access to the suggested decision rules through the MDCalc Connect EHR add-on application. Specific aims of the study are to determine if 1) patient-specific non-interruptive alerts increase the use of clinical decision rules amongst emergency medicine providers and 2) an increase in the use of clinical decision rules affects provider ordering habits.

Enrollment: 70 patients

Sex: All

Ages: 16+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Patient Inclusion Criteria:

• 16 years of age or older
• Qualifying chief complaint*

Patient Exclusion Criteria:

• None

  • A full list of the qualifying chief complaints is provided in Appendix A of the full research protocol.

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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70 participants in 2 patient groups

Intervention Group

Experimental group

Description:

The intervention will contain two components: 1) a non-interruptive best practice advisory (BPA) in the Epic Storyboard and 2) a default suggested calculator tab in the MDCalc Connect app. Six clinical decision rules will be included: Canadian CT Head Rule, Canadian C-spine Rule, HEART Score, PERC Rule, Wells' PE Criteria and Wells' DVT Criteria. Predefined criteria based on chief complaint, patient age and vital signs will be used to determine when a decision rule may be relevant in a patient encounter. When a patient meets all of the predefined criteria, the intervention will be triggered.

Treatment:

Other: Clinical Decision Rule Alerts

Control Group

No Intervention group

Description:

The control group will be usual care. Specifically, providers in the control group will not receive the clinical decision rule alert or the default suggested calculator tab in the MDCalc Connect app. The control group providers will have access to the MDCalc Connect app in its standard form and functionality.