Premium
The addition of decision support into computerized physician order entry reduces red blood cell transfusion resource utilization in the intensive care unit
Author(s) -
Pérez Evans R. Fernández,
Winters Jeffrey L.,
Gajic Ognjen
Publication year - 2007
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.20888
Subject(s) - medicine , psychological intervention , intensive care unit , computerized physician order entry , emergency medicine , clinical decision support system , anemia , red blood cell , order entry , blood transfusion , intervention (counseling) , intensive care medicine , packed red blood cells , medical emergency , decision support system , health care , nursing , artificial intelligence , computer science , economics , economic growth
Computerized physician order entry (CPOE) has the potential for cost containment in critically ill patients through practice standardization and elimination of unnecessary interventions. Previous study demonstrated the beneficial short‐term effect of adding a decision support for red blood cell (RBC) transfusion into the hospital CPOE. We evaluated the effect of such intervention on RBC resource utilization during the two‐year study period. From the institutional APACHE III database we identified 2,200 patients with anemia, but no active bleeding on admission: 1,100 during a year before and 1,100 during a year after the intervention. The mean number of RBC transfusions per patient decreased from 1.5 ± 1.9 units to 1.3 ± 1.8 units after the intervention ( P = 0.045). RBC transfusion cost decreased from $616,442 to $556,226 after the intervention. Hospital length of stay and adjusted hospital mortality did not differ before and after protocol implementation. In conclusion, the implementation of an evidenced‐based decision support system through a CPOE can decrease RBC transfusion resource utilization in critically ill patients. Am. J. Hematol., 2007. © 2007 Wiley‐Liss, Inc.