title: Effectiveness of Evidence-Based Congestive Heart Failure (CHF) CPOE Order Sets Measured by Health Outcomes.
abstract: OBJECTIVE
  Evidence-based order sets for treatment of patients with common conditions promise ordering efficiency and more consistent health outcomes. Despite ongoing utilization of order sets, quantitative evidence of their effectiveness is lacking. This study quantitatively analyzed benefits of CHF order sets as measured by mortality, readmission, and length of stay (LOS) outcomes.
  
  
  METHODS
  Mortality and readmissions were analyzed by comparing "order set" and "free text" groups of adult patients using logistic regression, Pearson chi-squared, and Fisher's exact methods. LOS was calculated by applying One-Way ANOVA and Mann-Whitney tests, supplemented by comorbidity analysis via Charlson Comorbidity Index.
  
  
  RESULTS
  CHF orders placed via sets were effective in reducing mortality [OR=1.818;95% CF 1.039-3.181;p=0.034] and LOS [F(1,10938)=8.352,p=0.013,4.75 days ("free text" group) vs. 5.46 days ("order set" group)], while readmission outcome was not significant [OR=0.913;95% CF 0.734-1.137;p=0.417].
  
  
  CONCLUSIONS
  Evidence-based medication ordering practices to treat CHF have potential to reduce mortality and LOS, without effect on readmissions.
authors.affiliation: Advocate Health Care, Oak Brook, IL ; Nova Southeastern University, Fort Lauderdale, FL ; University of Illinois at Chicago, Chicago, IL.
authors.forename: Jacob
authors.initials: J
authors.lastname: Krive
authors.affiliation: Advocate Health Care, Oak Brook, IL.
authors.forename: Joel S
authors.initials: JS
authors.lastname: Shoolin
authors.affiliation: Nova Southeastern University, Fort Lauderdale, FL ; Nevada System of Higher Education, NV.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Zink
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D050316:Medical Order Entry Systems; D010359:Patient Readmission / Q000706:statistics & numerical data
keywords: Evidence-based medicine; computerized physician order entry systems; congestive heart failure; health outcomes research; medication order sets