Quality Outcomes in the Surgical Intensive Care Unit after Electronic Health Record Implementation

Applied Clinical Informatics
V H FlatowR Kohli-Seth

Abstract

The electronic health record (EHR) is increasingly viewed as a means to provide more coordinated, patient-centered care. Few studies consider the impact of EHRs on quality of care in the intensive care unit (ICU) setting. To evaluate key quality measures of a surgical intensive care unit (SICU) following implementation of the Epic EHR system in a tertiary hospital. A retrospective chart review was undertaken to record quality indicators for all patients admitted to the SICU two years before and two years after EHR implementation. Data from the twelve-month period of transition to EHR was excluded. We collected length of stay, mortality, central line associated blood stream infection (CLABSI) rates, Clostridium difficile (C. diff.) colitis rates, readmission rates, and number of coded diagnoses. To control for variation in the patient population over time, the case mix indexes (CMIs) and APACHE II scores were also analyzed. There was no significant difference in length of stay, C. diff. colitis, readmission rates, or case mix index before and after EHR. After EHR implementation, the rate of central line blood stream infection (CLABSI) per 1 000 catheter days was 85% lower (2.16 vs 0.39; RR, 0.18; 95% CI, 0.05 to 0.61, p < .005),...Continue Reading

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Citations

Jun 25, 2016·The Journal of Surgical Research·Jamie R RobinsonGretchen P Jackson
Nov 7, 2018·Journal of Innovation in Health Informatics·Ward PriestmanNeil J Sebire
May 30, 2020·Annals of Surgery·Michael R Phillips
Oct 1, 2018·Journal of Medical Systems·Clemens Scott KruseHarmander Kaur
Jul 18, 2020·Annals of Surgery·Michael R Phillips
Oct 13, 2020·Computers, Informatics, Nursing : CIN·Sookyung Hyun, Cheryl Cooper

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