title: The addition of decision support into computerized physician order entry reduces red blood cell transfusion resource utilization in the intensive care unit.
abstract: Computerized physician order entry (CPOE) has the potential for cost containment in critically ill patients through practice standardization and elimination of unnecessary interventions. Previous study demonstrated the beneficial short-term effect of adding a decision support for red blood cell (RBC) transfusion into the hospital CPOE. We evaluated the effect of such intervention on RBC resource utilization during the two-year study period. From the institutional APACHE III database we identified 2,200 patients with anemia, but no active bleeding on admission: 1,100 during a year before and 1,100 during a year after the intervention. The mean number of RBC transfusions per patient decreased from 1.5 +/- 1.9 units to 1.3 +/- 1.8 units after the intervention (P = 0.045). RBC transfusion cost decreased from $616,442 to $556,226 after the intervention. Hospital length of stay and adjusted hospital mortality did not differ before and after protocol implementation. In conclusion, the implementation of an evidenced-based decision support system through a CPOE can decrease RBC transfusion resource utilization in critically ill patients.
authors.affiliation: Mayo Clinic College of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA. fernandez.evans@mayo.edu
authors.forename: Evans R
authors.initials: ER
authors.lastname: Fernández Pérez
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Winters
authors.forename: Ognjen
authors.initials: O
authors.lastname: Gajic
mesh_terms: D000368:Aged; D000740:Anemia / Q000473:pathology; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data; D003201:Computers / Q000191:economics; D020000:Decision Support Systems, Clinical; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D050316:Medical Order Entry Systems / Q000191:economics; D008875:Middle Aged; D016896:Treatment Outcome