Gastroenterology

Gastroenterology

Volume 163, Issue 4, October 2022, Pages e23-e24
Gastroenterology

Abstract
Targeting Quality Metrics in Cirrhosis: A Systems-Level Initiative to Improve Inpatient Cirrhosis Management

https://doi.org/10.1053/j.gastro.2022.07.030Get rights and content

Section snippets

Background

Quality metrics for inpatient cirrhosis management have been created to improve processes of care. We aimed to improve adherence to these quality metrics by creating a novel tool in the electronic health record (EHR).

Methods

This study was performed at the safety-net county teaching hospital affiliated with Indiana University. Baseline rates of adherence to quality metrics were established by retrospective chart review. We created and piloted a novel alert system in the EHR that directs providers to a cirrhosis order set when certain laboratory parameters are met. These parameters were identified through multivariable analysis of factors associated with confirmed cirrhosis diagnosis.

At the end of the pilot period,

Results

In 202 baseline encounters, multivariate analysis of pilot encounters indicated that Total Bilirubin [OR 1.31 (0.93, 1.89), p = .044], Serum Sodium [OR 5.19 (3.88, 7.10), p = .003], INR [OR 3.47 (2.79, 4.11), p = .031], and Platelets [OR 6.27 (4.32, 14.65), p = .001] were independently associated with a cirrhosis diagnosis.

The predictive alert correctly captured 81.8% of all patients with cirrhosis admitted during the pilot; 28.4% of alerted patients did not have cirrhosis. A total of 68

Conclusions

System-level EHR-based interventions may improve physician adherence to quality metrics for patients with cirrhosis. Further refinement of the intervention in larger samples are needed to refine the predictive model and better understand its impact on performance and outcome measures.

.

References (0)

Cited by (0)

Conflicts of interest The authors disclose no conflicts.

View full text