The addition of decision support into computerized physician order entry reduces red blood cell transfusion resource utilization in the intensive care unit.
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.
Fernández Pérez
Evans R
ER
Mayo Clinic College of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA. fernandez.evans@mayo.edu
Winters
Jeffrey L
JL
Gajic
Ognjen
O
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