Characteristics of Effective Best Practice Alerts for Hospital Providers: A Retrospective Database Analysis
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The Ohio State University / OhioLINK
2018
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| Online Access: | http://rave.ohiolink.edu/etdc/view?acc_num=osu1531777811293951 |
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ndltd-OhioLink-oai-etd.ohiolink.edu-osu15317778112939512021-08-03T07:07:43Z Characteristics of Effective Best Practice Alerts for Hospital Providers: A Retrospective Database Analysis Valvona, Sharon N. Health Care Clinical Decision Support Best Practice Advisory Objective: To assess whether design parameters for clinical decision support alerts used by providers encourage clinical decisions aligned with recommended actions by a hospital. We hypothesize that Best Practice Advisories (BPAs) that are aggressive in their presentation, allow selection of appropriate alternatives to recommended actions, and have simple information presentation and follow-up structures are correlated with a higher rate of correspondence with recommended actions.Design: A correlational study was performed on data retrospectively pulled from the electronic health record at a large academic medical center. Data consisted of all records for eleven BPAs returned by a query collecting data between June 25, 2014, and May 24, 2015. BPAs were selected based on use during the time period, as well as presented to physicians or physician extenders on patients admitted to the hospital. In addition, selected BPAs recommended at least one order as a follow-up action.Measurements: The outcome measure was the percent correspondence with recommended actions, as defined by either compliance with doing the recommended action or selecting an acceptable reason for not following the recommended action. Variables were whether a BPA was active or passive, required an action or not, the number of characters in the BPA header, the number of options for follow-up in the BPA dialog box, and the number of acknowledgment reasons that satisfied the BPA. We performed the analysis with a repeated measures regression model for the correlation of BPA design characteristics with the outcome measure of correspondence rate with recommended actions, including documentation of acceptable alternatives to an action aligned with policy. For the analysis of changes over time in BPA effectiveness, Mantel-Haenszel chi-square tests assessed whether there was a linear trend in the correspondence rate with recommended actions over time.Results: The level of intrusiveness of the BPA was significant such that the odds are 7.7 times greater than a recommended action would be taken by a provider with an active BPA after adjusting for whether an action was required. Findings were mixed regarding the relationship of simplicity of information presentation and follow-up structures and the outcome variable of correspondence rate with recommended actions. There was no reduction in the correspondence rate with recommendations over time during the study period.Conclusion: BPAs are more effective at changing behavior when there is an active presentation, regardless of whether or not an action is required by a BPA. A set of BPAs with a simple information presentation and follow-up structures with minimal workflow interruption did not experience a reduction in impact over time due to alert fatigue. 2018-10-08 English text The Ohio State University / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=osu1531777811293951 http://rave.ohiolink.edu/etdc/view?acc_num=osu1531777811293951 restricted--full text unavailable until 2023-08-06 This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
| collection |
NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Health Care Clinical Decision Support Best Practice Advisory |
| spellingShingle |
Health Care Clinical Decision Support Best Practice Advisory Valvona, Sharon N. Characteristics of Effective Best Practice Alerts for Hospital Providers: A Retrospective Database Analysis |
| author |
Valvona, Sharon N. |
| author_facet |
Valvona, Sharon N. |
| author_sort |
Valvona, Sharon N. |
| title |
Characteristics of Effective Best Practice Alerts for Hospital Providers: A Retrospective Database Analysis |
| title_short |
Characteristics of Effective Best Practice Alerts for Hospital Providers: A Retrospective Database Analysis |
| title_full |
Characteristics of Effective Best Practice Alerts for Hospital Providers: A Retrospective Database Analysis |
| title_fullStr |
Characteristics of Effective Best Practice Alerts for Hospital Providers: A Retrospective Database Analysis |
| title_full_unstemmed |
Characteristics of Effective Best Practice Alerts for Hospital Providers: A Retrospective Database Analysis |
| title_sort |
characteristics of effective best practice alerts for hospital providers: a retrospective database analysis |
| publisher |
The Ohio State University / OhioLINK |
| publishDate |
2018 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=osu1531777811293951 |
| work_keys_str_mv |
AT valvonasharonn characteristicsofeffectivebestpracticealertsforhospitalprovidersaretrospectivedatabaseanalysis |
| _version_ |
1719454458154319872 |