SHM Converge Scientific Abstract ePoster Gallery-Development of an Order Set to Modify Wasteful Recurring Orders

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The document describes the development of an EMR-based order set designed to help providers discontinue unnecessary recurring care in stable hospitalized patients. The targeted orders included daily electrolyte panels and CBCs, frequent vital signs, telemetry, continuous pulse oximetry, Foley catheters, nebulized bronchodilators, point-of-care glucose checks, and alcohol withdrawal monitoring. The order set used a dynamic design so that only relevant components appeared when an active order in that category already existed.<br /><br />The motivation was that automated recurring orders often continue throughout a hospital stay, even after a patient becomes clinically stable or moves to a lower-acuity setting. The team aimed to create a tool that would prompt review and discontinuation of these orders during transitions of care or when stability was recognized.<br /><br />Methods included a baseline review of one week of recurring-order usage in patients labeled “stable,” followed by iterative development through team discussion, section feedback, and pilot testing. The order set was built by an Epic physician builder. Promotion occurred through email, group chat, lectures, and meetings. Outcomes were assessed using interrupted time series analysis of low-risk days with daily BMPs, CBCs, overnight vital signs, and tube/tether orders.<br /><br />Results showed positive provider feedback on usability. Early data suggested a downward trend in daily BMPs, CBCs, vital-sign checks, and tube/tether orders, but the authors note that it is too early to draw firm conclusions.<br /><br />Overall, the project presents a promising approach to reducing wasteful recurring orders in stable inpatients, with data collection still ongoing.

Asset Subtitle

Khanh T. Nguyen

Meta Tag

Author List Aishwarya Katiki, Caleb J. Murphy, Khanh T. Nguyen, Matthew T. Cerasale, Vanshika Narala

Category Innovations

Concept Order Set

Concept Unnecessary Recurring Care

Concept Dynamic Order Set

Concept Stable Inpatients

Concept Daily Laboratory Test

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author Khanh T. Nguyen

Track Value in Hospital Medicine

Keywords

electronic medical record

order set

recurring orders

hospitalized patients

provider workflow

clinical stability

deprescribing

interrupted time series

daily labs

patient safety

Order Set

Unnecessary Recurring Care

Dynamic Order Set

Stable Inpatients

Daily Laboratory Test