TY - JOUR
T1 - Once-per-visit alerts
T2 - A means to study alert compliance and reduce repeat laboratory testing
AU - Szymanski, Jeffrey J.
AU - Qavi, Abraham J.
AU - Laux, Kari
AU - Jackups, Ronald
N1 - Publisher Copyright:
© 2019 American Association for Clinical Chemistry.
PY - 2019
Y1 - 2019
N2 - BACKGROUND: Clinical decision support alerts for laboratory testing have poor compliance. Once-per-visit alerts, triggered by reorder of a test within the same admission, are highly specific for unnecessary orders and provide a means to study alert compliance. METHODS: Once-per-visit alerts for 18 laboratory orderables were analyzed over a 60-month period from September 2012 to October 2016 at a 1200-bed academic medical center. To determine correlates of alert compliance, we compared alerts by test and provider characteristics. RESULTS: Overall alert compliance was 54.5%. In multivariate regression, compliance correlated with length of stay at time of alert, provider type, previous alerts in a patient visit, test ordered, total alerts experienced by ordering provider, and previous order status. CONCLUSIONS: A diverse set of provider and test characteristics influences compliance with once-per-visit laboratory alerts. Future alerts should incorporate these characteristics into alert design to minimize alert overrides.
AB - BACKGROUND: Clinical decision support alerts for laboratory testing have poor compliance. Once-per-visit alerts, triggered by reorder of a test within the same admission, are highly specific for unnecessary orders and provide a means to study alert compliance. METHODS: Once-per-visit alerts for 18 laboratory orderables were analyzed over a 60-month period from September 2012 to October 2016 at a 1200-bed academic medical center. To determine correlates of alert compliance, we compared alerts by test and provider characteristics. RESULTS: Overall alert compliance was 54.5%. In multivariate regression, compliance correlated with length of stay at time of alert, provider type, previous alerts in a patient visit, test ordered, total alerts experienced by ordering provider, and previous order status. CONCLUSIONS: A diverse set of provider and test characteristics influences compliance with once-per-visit laboratory alerts. Future alerts should incorporate these characteristics into alert design to minimize alert overrides.
UR - http://www.scopus.com/inward/record.url?scp=85071784949&partnerID=8YFLogxK
U2 - 10.1373/clinchem.2018.300657
DO - 10.1373/clinchem.2018.300657
M3 - Review article
C2 - 31296551
AN - SCOPUS:85071784949
SN - 0009-9147
VL - 65
SP - 1125
EP - 1131
JO - Clinical chemistry
JF - Clinical chemistry
IS - 9
ER -