Details:

Alternative Title:
Stroke
Personal Author:
Lakshminarayan, Kamakshi ; Rostambeigi, Nassir ; Fuller, Candace C. ; Peacock, James M. ; Tsai, Albert W.
Lakshminarayan, Kamakshi ; Rostambeigi, Nassir ; Fuller, Candace C. ; Peacock, James M. ; Tsai, Albert W. Less -
Description:
Background

Dysphagia screening (DS) prior to oral intake in acute stroke patients is a hospital level performance measure. Herein, we report outcomes of an initiative to improve compliance to this quality measure.

Methods

Design was a pre vs. post-intervention comparison study. Intervention was an Electronic Medical Record (EMR) based Clinical Decision Support system (CDS) embedded within stroke admission orders. The CDS was designed to facilitate DS in stroke patients. Primary outcome was compliance to a process measure in ischemic stroke patients: performance of a swallow screen prior to oral intake.

Results

DS measure compliance increased from 36% to 74% (p=0.001). Chart audits found screened patients were more likely to have CDS-embedded admission orders initiated or stroke unit admission.

Conclusion

The EMR offers a ready platform for CDS implementation. DS is a difficult performance measure to improve. The described CDS has the potential for improving performance on this challenging care quality measure.


Subject:
[+]
Acute Disease
Adolescent
Adult
Aged
Aged, 80 And Over
Article
Decision Support Techniques
Deglutition Disorders
Electronic Health Records
Female
Guideline Adherence
Humans
Male
Mass Screening
Middle Aged
Quality Of Health Care
Registries
Stroke
Young Adult

Source:
Stroke. 43(12):3399-3401.
Pubmed ID:
23033346
Pubmed Central ID:
PMC3508397
Document Type:
Journal Article
Funding:
K23 NS051377/NS/NINDS NIH HHS/United States ; U58 DP000857/DP/NCCDPHP CDC HHS/United States ; K23NS051377/NS/NINDS NIH HHS/United States
K23 NS051377/NS/NINDS NIH HHS/United States ; U58 DP000857/DP/NCCDPHP CDC HHS/United States ; K23NS051377/NS/NINDS NIH HHS/United States Less -
Place as Subject:
Minnesota
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:cbf1cde69ac49fec4d325fcb53e3f17c28017381b5a1fc28789ab77765d849fb
File Type:

Supporting Files

• 	nihms-414619-f0001.gif	gif
  	nihms-414619-f0001.jpg	jpeg
  	nihms-414619.nxml	xml
  	NIHMS414619-supplement-01.pdf	pdf

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