Utilizing clinical decision support within the electronic health record to screen for palliative care
View File(s)
- Author(s)
- Details
-
Tanja Baum, PhD, RN; Ruth A. Bush; Caroline Etland; Cynthia D. Connelly
- Sigma Affiliation
- Zeta Mu at-Large
Visitor Statistics
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Country | Visits |
---|
Top Visiting Cities
City | Visits |
---|
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Baum, Tanja by View
Title | Page Views |
---|
Popular Works for Baum, Tanja by Download
Title | Downloads |
---|
View Citations
Citations
Purpose: Timelier referral to palliative care services (PCS) within the acute care setting is a health care priority. End-of-life consumes a disproportionate share of healthcare dollars with studies indicating PCS can save hospitals approximately $1.3 million annually, for every 500 consults completed. Strategies to increase timelier referral are needed. Integration of electronic clinical decision support and utilization of triggers to identify individuals who may benefit from palliative care, using an algorithm embedded with the electronic health record (EHR) may facilitate this identification, but lacks empirical support.
The purpose of this research was to utilize variables available in the electronic healthcare record (EHR) of palliative care patients receiving PCS in the acute care setting to identify triggers which could be used to identify individuals who should be referred for PCS.
Specific Aims:
Aim 1: Characterize EHR data related to palliative care consultations among severely and chronically ill patients in the acute care.
Aim 2: Examine the relationships between the list of clinical EHR data, select demographics, 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. 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. Of these 51.7% were male, 65.4% White, 36.7% Christian, 80.8% English speaking, 49.7% Medicare recipients, 51.4% declared themselves as a ‘do-not-resuscitate’ and 97.6% were seen by a palliative care nurse. Significant associations were found between race/ethnicity/code status (X2 = 11.311, p .02), language/presence of advance directive (X2 = 13.845, p .008), and change of code status/loss of responsiveness (X2 =15.129, p<.001).
Conclusion: Using a large sample, a number of statistically significant demographic, physiologic, and clinical variables were found that to identify individuals suitable for timely referral to palliative care services. The integration of an EHR-based trigger system can aid not only nursing, but the interdisciplinary team to identify and refer potential palliative care patients in a timelier manner. The findings lay an important foundation for increased refinement of electronic clinical decision support within the EHR.
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship
Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository.
Type | Presentation |
Acquisition | Proxy-submission |
Review Type | Abstract Review Only: Reviewed by Event Host |
Format | Text-based Document |
Evidence Level | N/A |
Research Approach | N/A |
Keywords | Acute Care; Clinical Decision Support; Palliative Care |
Name | 28th International Nursing Research Congress |
Host | Sigma Theta Tau International |
Location | Dublin, Ireland |
Date | 2017 |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Related items
Showing items related by title, author, creator and subjects.
-
Screening for palliative care patients by utilizing clinical decision support within the electronic health record
Baum, Tanja; Bush, Ruth A.; Etland, Caroline; Connelly, Cynthia D. (2017-06-22)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 ... -
Interdisciplinary development of electronic palliative care decision support
Bush, Ruth A.; Connelly, Cynthia D.; Etland, Caroline; Baum, Tanja; Georges, Jane M. (2018-06-20)Following the session the attendee will be able to define palliative care and develop a greater understanding of the challenges and complexities in designing clinical decision support within the EHR for identification of ... -
Do community clinic patients have needed internet access and experience to use the patient portal?
Bush, Ruth A.; Barlow, Halsey; Perez, Alexa; Vazquez, Bianca; Mack, Jonathan; Connelly, Cynthia D.This study quantified whether patients attending a community clinic in southern California had the technology and internet experience to access the patient portal. There was no association between income and portal use. ... -
An innovative partnership paradigm: Patient engagement and health information technology curriculum for PhD nursing students
Bush, Ruth A.; Connelly, Cynthia D.; Roth, Patricia; Georges, Jane M.An innovative graduate level patient engagement and technology seminar was developed to impart engagement and health information technology skills to nurse scientists. The presentation will highlight topics and skills to ... -
Examining patient engagement with clinical technology: Demographic patterns of pediatric patient portal activation
Bush, Ruth A.; Vemulakonda, Vijaya M.; Richardson, Andrew; Davies, Sara Deakyne; Bojorquez, Genesis R.; Chiang, George J.EHRs of more than 42,000 patients at two geographically diverse pediatric specialty clinics were analyzed to identify 1) patients approached for patient portal access and 2) activated the portal. There were moderate ...