Key result
Although peer-to-peer promotion did not improve adoption, using the VTE clinical decision support tool significantly increased risk-appropriate prophylaxis prescribing compared to non-use (90% vs 71.5%; p=0.001).
Why the study?
An implemented electronic VTE prophylaxis clinical decision support tool at an Australian tertiary teaching hospital had not been clinically validated nor widely adopted.
Does a peer-to-peer promotion strategy improve the adoption of an electronic VTE prophylaxis clinical decision support tool and risk-appropriate prescribing in a tertiary hospital?
Observational (n=396)
No
Does a peer-to-peer promotion strategy improve the adoption of an electronic VTE prophylaxis clinical decision support tool and risk-appropriate prescribing in a tertiary hospital?
Absolute Event Rate: 90% vs 71.5%
p-value: p=0.001
While a peer-to-peer promotion strategy did not increase the adoption of an electronic VTE clinical decision support tool, actual use of the tool was associated with significantly higher rates of risk-appropriate VTE prophylaxis prescribing.
Use of VTE CDS was associated with higher appropriate prophylaxis prescribing; observational data leaves open how to increase adoption.
Background An electronic venous thromboembolism ( VTE ) prophylaxis clinical decision support ( CDS ) tool was implemented in an electronic medication management system at an Australian tertiary teaching hospital. The VTE CDS had not been clinically validated nor widely adopted. Aim This study evaluated the effectiveness of the VTE CDS for improving risk‐appropriate prescribing of VTE prophylaxis, a peer‐to‐peer strategy for improving adoption of the VTE CDS and the effects of the strategy on VTE risk assessment documentation, risk‐appropriate prophylaxis prescribing rate and user acceptability of the VTE CDS . Methods Nominated junior medical officers were trained to educate and promote the use of the VTE CDS to target colleagues over 6 weeks. Pre‐ and postintervention audits of VTE risk assessment and prophylaxis prescribing were conducted. A user acceptance survey was distributed. Results Analysis of pre‐ and postintervention audit data ( n = 198 for each) revealed no significant differences in rates of VTE CDS adoption or risk‐appropriate VTE prophylaxis prescribed. More patients had risk‐appropriate prophylaxis prescribed when the VTE CDS was used (90%; 63/70) than when it was not used (71.5% (233/326); p = 0.001). Documented evidence of VTE risk assessment increased significantly from 51.5% (102/198) to 68.2% (135/198) following the intervention (p < 0.001). Most survey responses were favourable towards VTE CDS usability despite limitations. Conclusion Peer‐to‐peer promotion was unsuccessful in improving VTE CDS adoption in this study. Findings suggest VTE CDS use is associated with more appropriate VTE prophylaxis prescribing decisions and may improve risk assessment documentation. Future studies should examine strategies to sustainably improve adoption of VTE CDS and patient outcomes.
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Soo et al. (2019) conducted an observational in Venous thromboembolism prophylaxis (n=396). Electronic VTE clinical decision support (CDS) tool vs. Non-use of VTE CDS tool was evaluated on Risk-appropriate VTE prophylaxis prescribed (p=0.001). Although peer-to-peer promotion did not improve adoption, using the VTE clinical decision support tool significantly increased risk-appropriate prophylaxis prescribing compared to non-use (90% vs 71.5%; p=0.001).
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