Impact of an EMR-based Clinical Decision Support Tool for Dysphagia Screening on Care Quality
Published Date:Oct 02 2012
Pubmed Central ID:PMC3508397
Funding:K23 NS051377/NS/NINDS NIH HHS/United States
K23NS051377/NS/NINDS NIH HHS/United States
U58 DP000857/DP/NCCDPHP CDC HHS/United States
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.
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.
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.
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.
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