• Electronic pneumonia decision support he

    From ScienceDaily@1:317/3 to All on Wednesday, March 09, 2022 21:30:48
    Electronic pneumonia decision support helps reduce mortality by 38
    percent in community hospitals

    Date:
    March 9, 2022
    Source:
    Intermountain Healthcare
    Summary:
    A real-time electronic decision support system helped clinicians
    at community hospitals provide best practice care for emergency
    department patients with pneumonia, resulting in decreased
    intensive care unit admission, more appropriate antibiotic use,
    and 38 percent lower overall mortality, according to a new study.



    FULL STORY ==========================================================================
    A real-time electronic decision support system helped clinicians at
    community hospitals provide best practice care for emergency department patients with pneumonia, resulting in decreased intensive care unit
    admission, more appropriate antibiotic use, and 38% lower overall
    mortality according to a new study by researchers at Intermountain
    Healthcare in Salt Lake City.


    ========================================================================== Results of the study are published online today in the American Journal
    of Respiratory and Critical Care Medicine.

    "Treating pneumonia in emergency departments is challenging, especially
    in community hospitals that don't see severe pneumonia as often as
    urban academic medical centers," said Nathan Dean, MD, section chief
    of pulmonary and critical care medicine at Intermountain Medical Center
    and principal investigator of this study.

    Pneumonia was the leading cause of death from infectious diseases in
    the United States, even before the COVID-19 pandemic, and continues to
    be a leading cause of death.

    In the study, researchers at Intermountain Healthcare deployed the health system's electronic, open loop, clinical decision support (ePNa) system
    to 16 of its community hospitals between December 2017 to June 2019.

    In that time, those hospitals had 6,848 pneumonia cases, and ePNa was
    used by a bedside clinician in 67% of eligible patients.



    ==========================================================================
    The Intermountain decision support tool gathers key patient indicators including age, fever, oxygen saturation, laboratory and chest imaging
    results, and vital signs to made recommendations on care, including
    appropriate antibiotic therapy, microbiology studies, and care setting recommendations (i.e., whether a patient should be sent to the ICU,
    admitted to the hospital, or is safe to go home).

    Using the tool, Intermountain researchers found a range of positive
    outcomes for patients, including:
    * 38% relative reduction in mortality 30 days after being diagnosed
    with
    pneumonia, with the largest reduction in mortality in patients
    admitted directly from the emergency department to the ICU
    * 17% increase in outpatient disposition * decreased intensive care
    unit admission without safety concerns * lowered mean time from
    emergency department admission to start of first
    antibiotic
    Researchers say results of the study are consistent with a prior study deploying ePNa in Intermountain's larger hospitals.

    "In giving clinicians a real-time assessment tool that pulls together over
    50 factors that can determine how a patient will do with pneumonia, our
    study found that clinicians were able to make better treatment decisions
    with this resource," noted Dr. Dean. "Some of our community hospitals have
    as little as 20 beds. We wanted to validate the effectiveness of ePNa
    in very different healthcare settings." During the time of this study,
    U.S. News and World Report also ranked Intermountain as high performing
    in pneumonia care with excellent outcomes.

    Dr. Dean added that not only did ePNa make recommendations that helped clinicians, but it also enabled clinicians to be more structured and
    consistent in making decisions about patients with pneumonia.

    "Even if they don't follow the recommendation, decision-making is more consistent with best practices," he said.

    For example, ePNa might recommend a patient be admitted to the intensive
    care unit, but a clinician knows that it's not the right care setting
    for an elderly, stage IV cancer patient.


    ========================================================================== Story Source: Materials provided by Intermountain_Healthcare. Note:
    Content may be edited for style and length.


    ========================================================================== Journal Reference:
    1. Nathan C Dean, Caroline G Vines, Jason R. Carr, Jenna G. Rubin,
    Brandon J
    Webb, Jason R Jacobs, Allison M. Butler, Jaehoon Lee, Al R Jephson,
    Nathan Jenson, Missy Walker, Samuel M Brown, Jeremy A Irvin,
    Matthew P.

    Lungren, Todd L. Allen. A Pragmatic Stepped-wedge,
    Cluster-controlled Trial of Real-time Pneumonia Clinical Decision
    Support. American Journal of Respiratory and Critical Care Medicine,
    2022; DOI: 10.1164/ rccm.202109-2092OC ==========================================================================

    Link to news story: https://www.sciencedaily.com/releases/2022/03/220309104421.htm

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