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April 4, 2013American Journal of Hematology

Impact of a venous thromboembolism prophylaxis “smart order set”: Improved compliance, fewer events

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Why the study?

Does a computerized clinical decision support-enabled smart order set improve prescription of risk-appropriate VTE prophylaxis and reduce symptomatic VTE in patients admitted to a Medicine service?

Population

1,942 consecutive patients admitted to the Medicine service.

Comparison

Mandatory computerized clinical decision… vs Standard practice prior to the implementation of…

Design

Cohort

Follow-up

90 days post-discharge

Authors

AZAmer M. ZeidanYale Cancer CenterMSMichael B. StreiffVascular MedicineBLBrandyn LauJohns Hopkins University

Discussion

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Implication

Supports smart order sets for VTE prophylaxis in medicine services; leaves open whether randomized trials confirm VTE reduction.

Structured PICO

Does a computerized clinical decision support-enabled smart order set improve prescription of risk-appropriate VTE prophylaxis and reduce symptomatic VTE in patients admitted to a Medicine service?

P
Population
1,942 consecutive patients admitted to the Medicine service (1,000 in the pre-implementation cohort, 942 in the post-implementation cohort).
I
Intervention
Mandatory computerized clinical decision support-enabled 'smart order sets' requiring providers to assess VTE risk factors and contraindications to recommend evidence-based risk-appropriate VTE prophylaxis.
C
Comparator
Standard practice prior to the implementation of the 'smart order set' (November 2007).
O
Outcome
Prescription of risk-appropriate VTE prophylaxis.

Implementation of a mandatory computerized clinical decision support tool for VTE prophylaxis significantly improved guideline-concordant prescribing and reduced symptomatic VTE events without increasing bleeding risk.

Cite This Study

Zeidan et al. (2013) studied this question.

synapsesocial.com/papers/6a0f5de19e54838161fca642https://doi.org/10.1002/ajh.23450
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Also Consider

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