Reduction in Clinical Variance Using Targeted Design Changes in Computerized Provider Order Entry Order (CPOE) Sets

May 19, 2015 updated by: Brian Jacobs
Selective redesign of order sets using different ways to frame the order and physician decision-making in a computerized provider order entry system could increase adherence to evidence-based care and reduce population-specific variance.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Variance in ordering of care can be characterized as the lack of uniform use of specific treatments by clinicians for a given medical condition. Unwarranted variance in healthcare has been associated with prolonged length of stay, diminished health and increased cost. Practice variation in the management of asthma can be significant and few investigators have evaluated strategies to reduce this variation. We hypothesized that selective redesign of order sets using different ways to frame the order and physician decision-making in a computerized provider order entry system could increase adherence to evidence-based care and reduce population-specific variance.

Study Type

Interventional

Enrollment (Actual)

458

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Ohio
      • Cincinnati, Ohio, United States, 45229
        • Cincinnati Children's Hospital Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • All patients admitted using an acute asthma exacerbation order set.

Exclusion Criteria:

  • Patients who did not have either an admission or discharge diagnosis of asthma exacerbation.
  • In addition, patients admitted to the intensive care unit directly or transferred to the intensive care unit within 24-hours were excluded from analysis.
  • Finally, patients were excluded from analysis if asthma was not the presenting problem.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Non-Randomized
  • Interventional Model: Factorial Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Baseline Period
Patients in the baseline period were cared for using the standard historical electronic order set.
Active Comparator: Post Intervention Period
Patients in the Post intervention period were cared for with evidence-bsed modified order set changes
Other: Evidence Based Intervention to order set
The order set was altered to include evidence based care items

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Reduced variation from in evidence-based care through integrating evidence into the clinician workflow in the EMR system.
Time Frame: 2 years
2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Brian Jacobs

Collaborators

Siemens Medical

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2004

Primary Completion (Actual)

December 1, 2006

Study Completion (Actual)

December 1, 2006

Study Registration Dates

First Submitted

July 24, 2009

First Submitted That Met QC Criteria

August 4, 2009

First Posted (Estimate)

August 6, 2009

Study Record Updates

Last Update Posted (Estimate)

May 21, 2015

Last Update Submitted That Met QC Criteria

May 19, 2015

Last Verified

May 1, 2015

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 05-11-34

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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