A real-time electronic decision support system helps community hospitals improve ED care for pneumonia, according to a study published in the American Journal of Respiratory and Critical Care Medicine. Nathan C. Dean, MD, and colleagues evaluated rollout of the decision support system for treating pneumonia at 16 community hospital EDs for 3 years. Unadjusted mortality rates were 8.6% before and 4.8% after deployment. When adjusting for illness severity with hospital cluster, the random effect model showed lower odds for 30-day all-cause mortality after deployment (OR, 0.62). Across hospital clusters, lower mortality was seen. With the support system, concordant antibiotic prescribing increased from 83.5% to 90.2%. There was a decline observed in mean time from ED admission to first antibiotic (159.4 minutes at baseline to 150.9 minutes) and an increase in outpatient disposition from the ED (29.2% to 46.9%). “In giving clinicians a real-time assessment tool that pulls together over 50 factors that can determine how a patient will do with pneumonia, our study found that clinicians were able to make better treatment decisions with this resource,” Dr. Dean said in a statement.
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