Impact of an EMR-based Clinical Decision Support Tool for Dysphagia Screening on Care Quality

Details

• Alternative Title:
  Stroke
• Personal Author:
  Lakshminarayan, Kamakshi ; Rostambeigi, Nassir ; Fuller, Candace C. ; Peacock, James M. ; Tsai, Albert W.
• 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.
  
  
• Subjects:
  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

  More +
• 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
• Place as Subject:
  Minnesota
• Volume:
  43
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:cbf1cde69ac49fec4d325fcb53e3f17c28017381b5a1fc28789ab77765d849fb
• Download URL:
  https://stacks.cdc.gov/view/cdc/33479/cdc_33479_DS1.pdf
• File Type:
  [PDF - 411.62 KB ]