SHM Converge Scientific Abstract ePoster Gallery-Comparing Ehr Alerts to Reduce Lab-Ordering for Medically Ready Patients

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This project evaluated whether redesigning an electronic health record best practice alert (BPA) could reduce unnecessary daily lab ordering for hospitalized patients who are medically ready for discharge, especially those awaiting post-acute placement.<br /><br />Unnecessary daily labs can increase costs, waste resources, cause iatrogenic anemia, and create patient discomfort. The team focused on improving provider response to a BPA that alerts clinicians when a patient has been marked “medically ready.” The original BPA launched in March 2023, and a redesigned version went live on November 1, 2023. The new design used a clearer heading, a distinct color, and the ABIM “Choosing Wisely” logo to improve visibility and workflow integration.<br /><br />The study was conducted at an academic tertiary medical center across two hospitalist resident services and one short-stay unit. Data were collected from March 2023 through March 2024, tracking how often each BPA fired and whether providers acted on it in either the sidebar/storyboard or the “Manage Orders” pop-up.<br /><br />Results showed that the pop-up alert prompted more action than the storyboard/sidebar alert. For the original BPA, the storyboard fired 52 times and was never acted upon, while the pop-up fired 8 times and was enacted 3 times (38%). For the redesigned BPA, the storyboard fired 26 times and was never acted upon, while the pop-up fired 2 times and was never acted upon.<br /><br />Overall, the findings suggest providers respond more to pop-up alerts than storyboard alerts. Although early data are limited, the redesigned BPA may better fit provider workflow and potentially improve lab stewardship. Further data collection and expansion to other services are planned.

Asset Subtitle

Nicole Gras

Meta Tag

Author List Matthew Cerasale, Nicole Gras, Shannon K. Martin

Category Innovations

Concept Laboratory Overuse

Concept Best Practice Alert

Concept Discharge Laboratory Test

Concept Provider Interaction

Concept Pop-up Alert

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author Nicole Gras

Track Quality Improvement

Keywords

electronic health record

best practice alert

daily lab ordering

hospitalized patients

medically ready for discharge

post-acute placement

alert redesign

lab stewardship

provider response

pop-up alert

Laboratory Overuse

Best Practice Alert

Discharge Laboratory Test

Provider Interaction

Pop-up Alert