Screening for Palliative Care Patients By Utilizing Clinical Decision Support Within the Electronic Health Record

2.50
Hdl Handle:
http://hdl.handle.net/10755/621574
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Screening for Palliative Care Patients By Utilizing Clinical Decision Support Within the Electronic Health Record
Author(s):
Baum, Tanja; Bush, Ruth A.; Etland, Caroline; Connelly, Cynthia D.
Lead Author STTI Affiliation:
Zeta Mu-at-Large
Author Details:
Tanja Baum, PhD, RN, Professional Experience: 08/2011-11/2013 Critical Care Registered Nurse, Whittier Hospital, Whittier, CA 06/2013-present Critical Care Registered Nurse, PIH Health, Whittier, CA 08/2016-present Clinical Faculty, Hahn School of Nursing and Health Science, Universtity of San Diego Author Summary: Ms. Baum's research interest are focused on patient-centered outcomes given her professional background in critical care. As a new researcher she had the opportunity to work with experienced researchers and multi-disciplinary teams across populations. These populations include but are not limited to third world country, maternity, end-of-life, as well as adult critically ill patients.
Abstract:

Purpose

Approximately $1.3 million annually can be saved when 500 palliative care consults are completed within the acute care setting. With 90 million Americans, of whom 20% are Medicare recipients that suffer from chronic medical conditions, 500 consults are not a distant number. The electronic clinical decision support and utilization of triggers to identify individuals who might benefit from palliative care using an algorithm within the electronic health record (EHR) can enable the multidisciplinary team to facilitate palliative care services.

The purpose of this feasibility study was to utilize variables available in the EHR of palliative care patients receiving palliative care services (PCS) in the acute care setting.

Aim 1) Characterize EHR data related to palliative care consultations among severely and chronically ill patients in the acute care

Aim 2) Examine relationships between the list of clinical EHR data, and select demographics (age, gender, race, ethnicity, religion), in a sample of palliative care patients

Methods

A descriptive, correlational study using de-identified retrospective data, collected from January 1, 2013 to December 31, 2015. An institutionally derived list of variables was used to provide a foundation for clinical decision support and patient identification integrated into the Cerner EHR system. Data were derived from three hospitals of a large multi-community healthcare system in San Diego County, California (USA). Descriptive and inferential statistical analyses conducted using SPSS version 23.

Results

A randomized sample yielded 694 palliative care patients seeking acute care treatment at one of the three hospitals. Significant associations were found between patients' race/ethnicity and code status (X2= 11.26, p .16), and language and the presence of an advance directive or physician orders for life-sustaining treatment (POLST) (X2= 13.845, p .008).

Conclusion

Using a large sample, a number of statistically significant demographic, physiologic, and clinical variables were found. Integrating the EHR system to its fullest can not only aid nursing, but the entire interdisciplinary team in enhancing quality of life of palliative care patients and their families. Documents such as the advance directive or the POLST can be saved electronically and are readily available throughout the entire hospital system. Furthermore, multiple translated versions may be available for the patient, decreasing language barriers that could prevent patients from making their wishes known. Further research is needed to include the entire hospital popoulation and to extend beyond a single healthcare system to increase diversity.

Keywords:
Clinical Decision Support; Electronic Health Record; Palliative Care
Repository Posting Date:
22-Jun-2017
Date of Publication:
22-Jun-2017
Other Identifiers:
INRC17PST694
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleScreening for Palliative Care Patients By Utilizing Clinical Decision Support Within the Electronic Health Recorden_US
dc.contributor.authorBaum, Tanjaen
dc.contributor.authorBush, Ruth A.en
dc.contributor.authorEtland, Carolineen
dc.contributor.authorConnelly, Cynthia D.en
dc.contributor.departmentZeta Mu-at-Largeen
dc.author.detailsTanja Baum, PhD, RN, Professional Experience: 08/2011-11/2013 Critical Care Registered Nurse, Whittier Hospital, Whittier, CA 06/2013-present Critical Care Registered Nurse, PIH Health, Whittier, CA 08/2016-present Clinical Faculty, Hahn School of Nursing and Health Science, Universtity of San Diego Author Summary: Ms. Baum's research interest are focused on patient-centered outcomes given her professional background in critical care. As a new researcher she had the opportunity to work with experienced researchers and multi-disciplinary teams across populations. These populations include but are not limited to third world country, maternity, end-of-life, as well as adult critically ill patients.en
dc.identifier.urihttp://hdl.handle.net/10755/621574-
dc.description.abstract<p><strong>Purpose</strong></p> <p>Approximately $1.3 million annually can be saved when 500 palliative care consults are completed within the acute care setting. With 90 million Americans, of whom 20% are Medicare recipients that suffer from chronic medical conditions, 500 consults are not a distant number. The electronic clinical decision support and utilization of triggers to identify individuals who might benefit from palliative care using an algorithm within the electronic health record (EHR) can enable the multidisciplinary team to facilitate palliative care services.</p> <p>The purpose of this feasibility study was to utilize variables available in the EHR of palliative care patients receiving palliative care services (PCS) in the acute care setting.</p> <p>Aim 1) Characterize EHR data related to palliative care consultations among severely and chronically ill patients in the acute care</p> <p>Aim 2) Examine relationships between the list of clinical EHR data, and select demographics (age, gender, race, ethnicity, religion), in a sample of palliative care patients</p> <p><strong>Methods</strong></p> <p>A descriptive, correlational study using de-identified retrospective data, collected from January 1, 2013 to December 31, 2015. An institutionally derived list of variables was used to provide a foundation for clinical decision support and patient identification integrated into the Cerner EHR system. Data were derived from three hospitals of a large multi-community healthcare system in San Diego County, California (USA). Descriptive and inferential statistical analyses conducted using SPSS version 23.</p> <p><strong>Results</strong></p> <p>A randomized sample yielded 694 palliative care patients seeking acute care treatment at one of the three hospitals. Significant associations were found between patients' race/ethnicity and code status (X<sup>2</sup>= 11.26, p .16), and language and the presence of an advance directive or physician orders for life-sustaining treatment (POLST) (X<sup>2</sup>= 13.845, p .008).</p> <p><strong>Conclusion</strong></p> <p>Using a large sample, a number of statistically significant demographic, physiologic, and clinical variables were found. Integrating the EHR system to its fullest can not only aid nursing, but the entire interdisciplinary team in enhancing quality of life of palliative care patients and their families. Documents such as the advance directive or the POLST can be saved electronically and are readily available throughout the entire hospital system. Furthermore, multiple translated versions may be available for the patient, decreasing language barriers that could prevent patients from making their wishes known. Further research is needed to include the entire hospital popoulation and to extend beyond a single healthcare system to increase diversity.</p>en
dc.subjectClinical Decision Supporten
dc.subjectElectronic Health Recorden
dc.subjectPalliative Careen
dc.date.available2017-06-22T14:11:47Z-
dc.date.issued2017-06-22-
dc.date.accessioned2017-06-22T14:11:47Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.