HealthDay News — A real-time electronic decision support system helps clinicians at community hospitals improve emergency department care for patients with pneumonia, according to a study published online March 7 in the American Journal of Respiratory and Critical Care Medicine.
Nathan C. Dean, M.D., from Intermountain Medical Center in Murray, Utah, and colleagues evaluated rollout of real-time, electronic decision support for treatment of patients with pneumonia at 16 community hospital emergency departments over three years.
The researchers found that unadjusted mortality was 8.6 percent before and 4.8 percent after deployment. When adjusting for severity of illness with hospital cluster, the random effect model showed lower odds for 30-day all-cause mortality after deployment (adjusted odds ratio, 0.62). Across hospital clusters, lower mortality was seen. With the clinical decision support system, concordant antibiotic prescribing increased from 83.5 to 90.2 percent. There was a decline observed in mean time from emergency department admission to first antibiotic after deployment (159.4 minutes at baseline to 150.9 minutes). There was also an increase seen in outpatient disposition from the emergency department (29.2 to 46.9 percent). Seven-day secondary hospital admission was unchanged. The decision support system was used by emergency department clinicians in two-thirds of eligible patients.
“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,” Dean said in a statement.