Jennifer L Reed1, Judith W Dexheimer2, Andrea M Kachelmeyer3, Maurizio Macaluso4, Evaline A Alessandrini5, Jessica A Kahn6. 1. Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio. Electronic address: Jennifer.Reed@cchmc.org. 2. Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 3. Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 4. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 5. Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; University of Cincinnati Health System, Cincinnati, Ohio. 6. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Abstract
PURPOSE: The aim of the study was to design and implement a novel, universally offered, computerized clinical decision support (CDS) gonorrhea and chlamydia (GC/CT) screening tool embedded in the emergency department (ED) clinical workflow and triggered by patient-entered data. METHODS: The study consisted of the design and implementation of a tablet-based screening tool based on qualitative data of adolescent and parent/guardian acceptability of GC/CT screening in the ED and an advisory committee of ED leaders and end users. The tablet was offered to adolescents aged 14-21 years and informed patients of Centers for Disease Control and Prevention GC/CT screening recommendations, described the testing process, and assessed whether patients agreed to testing. The tool linked to CDS that streamlined the order entry process. The primary outcome was the patient capture rate (proportion of patients with tablet data recorded). The secondary outcomes included rates of patient agreement to GC/CT testing and provider acceptance of the CDS. RESULTS: Outcomes at the main and satellite EDs, respectively, were as follows: 1-year patient capture rates were 64.6% and 64.5%; 9.9% and 4.4% of patients agreed to GC/CT testing, and of those, the provider ordered testing for 73% and 72%. CONCLUSIONS: Implementation of this computerized screening tool embedded in the clinical workflow resulted in patient capture rates of almost two-thirds and clinician CDS acceptance rates >70% with limited patient agreement to testing. This screening tool is a promising method for confidential GC/CT screening among youth in an ED setting. Additional interventions are needed to increase adolescent agreement for GC/CT testing.
PURPOSE: The aim of the study was to design and implement a novel, universally offered, computerized clinical decision support (CDS) gonorrhea and chlamydia (GC/CT) screening tool embedded in the emergency department (ED) clinical workflow and triggered by patient-entered data. METHODS: The study consisted of the design and implementation of a tablet-based screening tool based on qualitative data of adolescent and parent/guardian acceptability of GC/CT screening in the ED and an advisory committee of ED leaders and end users. The tablet was offered to adolescents aged 14-21 years and informed patients of Centers for Disease Control and Prevention GC/CT screening recommendations, described the testing process, and assessed whether patients agreed to testing. The tool linked to CDS that streamlined the order entry process. The primary outcome was the patient capture rate (proportion of patients with tablet data recorded). The secondary outcomes included rates of patient agreement to GC/CT testing and provider acceptance of the CDS. RESULTS: Outcomes at the main and satellite EDs, respectively, were as follows: 1-year patient capture rates were 64.6% and 64.5%; 9.9% and 4.4% of patients agreed to GC/CT testing, and of those, the provider ordered testing for 73% and 72%. CONCLUSIONS: Implementation of this computerized screening tool embedded in the clinical workflow resulted in patient capture rates of almost two-thirds and clinician CDS acceptance rates >70% with limited patient agreement to testing. This screening tool is a promising method for confidential GC/CT screening among youth in an ED setting. Additional interventions are needed to increase adolescent agreement for GC/CT testing.
Authors: Abigail Silva; Nancy R Glick; Sheryl B Lyss; Angela B Hutchinson; Thomas L Gift; Lisa N Pealer; Dawn Broussard; Steven Whitman Journal: Ann Emerg Med Date: 2006-11-20 Impact factor: 5.721
Authors: Fahd A Ahmad; Donna B Jeffe; Katie Plax; Karen K Collins; Kenneth B Schechtman; Dwight E Doerhoff; Jane Garbutt; David M Jaffe Journal: Ann Emerg Med Date: 2014-03-06 Impact factor: 5.721
Authors: Jennifer L Reed; Brittany E Punches; Regina G Taylor; Maurizio Macaluso; Evaline A Alessandrini; Jessica A Kahn Journal: Ann Emerg Med Date: 2017-05-27 Impact factor: 5.721
Authors: Gordon Lee Gillespie; Jennifer Reed; Carolyn K Holland; Jennifer Knopf Munafo; Rachael Ekstrand; Maria T Britto; Jill Huppert Journal: Adv Emerg Nurs J Date: 2013 Jan-Mar