Sinusitis treatment guideline adherence in the e-visit setting

A performance improvement project

Kevin L. Smith, Dang Tran, Bonnie L Westra

Research output: Contribution to journalArticle

Abstract

Background: Studies demonstrate poor guideline adherence by health care providers for the treatment of upper respiratory infections, particularly acute bacterial rhinosinusitis (ABRS), in the appropriate prescribing of antibiotic medications. Objective: The purpose of this quality improvement project was to evaluate the effect of implementing interventions for improving adherence to a clinical practice guideline for the management of ABRS for patients treated in the e-visit setting. Interventions included: providing a report to providers of their adherence to the ABRS clinical guideline prior to the intervention, providing updated education on the ABRS guideline, and implementing a clinical decision support system reminder. Methods: A pre and post intervention evaluation design was used. Data were obtained from a retrospective electronic health record (EHR) data extract of all 316 diagnoses for ABRS in the preintervention 2-month time period and all 368 diagnoses of ABRS in the post-intervention 2-month time period. A review of the structured clinical data elements was performed to determine whether the provider adhered to the clinical guideline, meaning that only patients meeting the criteria for ABRS were to receive an antibiotic prescription. Results and Conclusion: The interventions resulted in a 3.3% improvement in adherence to the ABRS clinical guideline from 95.25% adherence pre-intervention to 98.4% post-intervention. These results demonstrated that the use of an educational intervention and clinical decision support resulted in improved adherence to the ABRS clinical guideline in the e-visit setting. The implications for practice could be significant in that these quality improvement interventions improve guideline adherence and reduce unnecessary prescribing of antibiotics.

Original languageEnglish (US)
Pages (from-to)299-307
Number of pages9
JournalApplied clinical informatics
Volume7
Issue number2
DOIs
StatePublished - May 11 2016

Fingerprint

Guideline Adherence
Sinusitis
Antibiotics
Clinical Decision Support Systems
Guidelines
Quality Improvement
Anti-Bacterial Agents
Decision support systems
Health care
Electronic Health Records
Practice Management
Therapeutics
Education
Practice Guidelines
Health
Respiratory Tract Infections
Health Personnel
Prescriptions

Keywords

  • Acute bacterial rhinosinusitis (ABRS)
  • Clinical decision support systems
  • Guideline adherence
  • Informatics
  • Quality improvement
  • e-visit

Cite this

Sinusitis treatment guideline adherence in the e-visit setting : A performance improvement project. / Smith, Kevin L.; Tran, Dang; Westra, Bonnie L.

In: Applied clinical informatics, Vol. 7, No. 2, 11.05.2016, p. 299-307.

Research output: Contribution to journalArticle

Smith, Kevin L. ; Tran, Dang ; Westra, Bonnie L. / Sinusitis treatment guideline adherence in the e-visit setting : A performance improvement project. In: Applied clinical informatics. 2016 ; Vol. 7, No. 2. pp. 299-307.
@article{98405049780c4f3899ff4f41682195fb,
title = "Sinusitis treatment guideline adherence in the e-visit setting: A performance improvement project",
abstract = "Background: Studies demonstrate poor guideline adherence by health care providers for the treatment of upper respiratory infections, particularly acute bacterial rhinosinusitis (ABRS), in the appropriate prescribing of antibiotic medications. Objective: The purpose of this quality improvement project was to evaluate the effect of implementing interventions for improving adherence to a clinical practice guideline for the management of ABRS for patients treated in the e-visit setting. Interventions included: providing a report to providers of their adherence to the ABRS clinical guideline prior to the intervention, providing updated education on the ABRS guideline, and implementing a clinical decision support system reminder. Methods: A pre and post intervention evaluation design was used. Data were obtained from a retrospective electronic health record (EHR) data extract of all 316 diagnoses for ABRS in the preintervention 2-month time period and all 368 diagnoses of ABRS in the post-intervention 2-month time period. A review of the structured clinical data elements was performed to determine whether the provider adhered to the clinical guideline, meaning that only patients meeting the criteria for ABRS were to receive an antibiotic prescription. Results and Conclusion: The interventions resulted in a 3.3{\%} improvement in adherence to the ABRS clinical guideline from 95.25{\%} adherence pre-intervention to 98.4{\%} post-intervention. These results demonstrated that the use of an educational intervention and clinical decision support resulted in improved adherence to the ABRS clinical guideline in the e-visit setting. The implications for practice could be significant in that these quality improvement interventions improve guideline adherence and reduce unnecessary prescribing of antibiotics.",
keywords = "Acute bacterial rhinosinusitis (ABRS), Clinical decision support systems, Guideline adherence, Informatics, Quality improvement, e-visit",
author = "Smith, {Kevin L.} and Dang Tran and Westra, {Bonnie L}",
year = "2016",
month = "5",
day = "11",
doi = "10.4338/ACI-2015-10-CR-0143",
language = "English (US)",
volume = "7",
pages = "299--307",
journal = "Applied Clinical Informatics",
issn = "1869-0327",
publisher = "Schattauer GmbH",
number = "2",

}

TY - JOUR

T1 - Sinusitis treatment guideline adherence in the e-visit setting

T2 - A performance improvement project

AU - Smith, Kevin L.

AU - Tran, Dang

AU - Westra, Bonnie L

PY - 2016/5/11

Y1 - 2016/5/11

N2 - Background: Studies demonstrate poor guideline adherence by health care providers for the treatment of upper respiratory infections, particularly acute bacterial rhinosinusitis (ABRS), in the appropriate prescribing of antibiotic medications. Objective: The purpose of this quality improvement project was to evaluate the effect of implementing interventions for improving adherence to a clinical practice guideline for the management of ABRS for patients treated in the e-visit setting. Interventions included: providing a report to providers of their adherence to the ABRS clinical guideline prior to the intervention, providing updated education on the ABRS guideline, and implementing a clinical decision support system reminder. Methods: A pre and post intervention evaluation design was used. Data were obtained from a retrospective electronic health record (EHR) data extract of all 316 diagnoses for ABRS in the preintervention 2-month time period and all 368 diagnoses of ABRS in the post-intervention 2-month time period. A review of the structured clinical data elements was performed to determine whether the provider adhered to the clinical guideline, meaning that only patients meeting the criteria for ABRS were to receive an antibiotic prescription. Results and Conclusion: The interventions resulted in a 3.3% improvement in adherence to the ABRS clinical guideline from 95.25% adherence pre-intervention to 98.4% post-intervention. These results demonstrated that the use of an educational intervention and clinical decision support resulted in improved adherence to the ABRS clinical guideline in the e-visit setting. The implications for practice could be significant in that these quality improvement interventions improve guideline adherence and reduce unnecessary prescribing of antibiotics.

AB - Background: Studies demonstrate poor guideline adherence by health care providers for the treatment of upper respiratory infections, particularly acute bacterial rhinosinusitis (ABRS), in the appropriate prescribing of antibiotic medications. Objective: The purpose of this quality improvement project was to evaluate the effect of implementing interventions for improving adherence to a clinical practice guideline for the management of ABRS for patients treated in the e-visit setting. Interventions included: providing a report to providers of their adherence to the ABRS clinical guideline prior to the intervention, providing updated education on the ABRS guideline, and implementing a clinical decision support system reminder. Methods: A pre and post intervention evaluation design was used. Data were obtained from a retrospective electronic health record (EHR) data extract of all 316 diagnoses for ABRS in the preintervention 2-month time period and all 368 diagnoses of ABRS in the post-intervention 2-month time period. A review of the structured clinical data elements was performed to determine whether the provider adhered to the clinical guideline, meaning that only patients meeting the criteria for ABRS were to receive an antibiotic prescription. Results and Conclusion: The interventions resulted in a 3.3% improvement in adherence to the ABRS clinical guideline from 95.25% adherence pre-intervention to 98.4% post-intervention. These results demonstrated that the use of an educational intervention and clinical decision support resulted in improved adherence to the ABRS clinical guideline in the e-visit setting. The implications for practice could be significant in that these quality improvement interventions improve guideline adherence and reduce unnecessary prescribing of antibiotics.

KW - Acute bacterial rhinosinusitis (ABRS)

KW - Clinical decision support systems

KW - Guideline adherence

KW - Informatics

KW - Quality improvement

KW - e-visit

UR - http://www.scopus.com/inward/record.url?scp=84968538247&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84968538247&partnerID=8YFLogxK

U2 - 10.4338/ACI-2015-10-CR-0143

DO - 10.4338/ACI-2015-10-CR-0143

M3 - Article

VL - 7

SP - 299

EP - 307

JO - Applied Clinical Informatics

JF - Applied Clinical Informatics

SN - 1869-0327

IS - 2

ER -