SHM Converge Scientific Abstract ePoster Gallery-Reduction in the Use of Gastrointestinal Pathogens Panel by PCR in a Large Public Safety Net Hospital System

Reduction in the Use of Gastrointestinal Pathogens Panel by PCR in a Large Public Safety Net Hospital System

Pdf Summary

This project evaluated whether a standardized electronic health record order set could reduce unnecessary stool testing for hospitalized patients with diarrhea in a large public safety net hospital.

The rationale was that diarrhea occurring after three or more hospital days is more likely due to <em>C. difficile</em> than other infectious causes, and the diagnostic yield of the Gastrointestinal Pathogens Panel (GPP) by PCR drops substantially after the first few days of hospitalization. To address overuse, the team created an inpatient diarrhea order set that included guidance on when GPP by PCR is appropriate based on length of stay. In the inpatient setting, GPP by PCR could only be ordered through this order set.

The intervention was first implemented on 4/4/2025, but technical issues led to its temporary removal. It was re-implemented on 6/25/2025. Outcomes were compared across three periods: pre-intervention, washout, and post-intervention.

Results showed meaningful reductions in testing after implementation. GPP by PCR orders decreased by 34.6% (p < 0.001), and <em>C. difficile</em> tests decreased by 18.6% (p = 0.0057).

The conclusion is that a simple EMR-based order set can significantly reduce unnecessary gastrointestinal pathogen testing in hospitalized patients with diarrhea. This approach may be a useful, scalable model for other institutions, especially those with limited resources.

Asset Subtitle

Ian Fagan

Meta Tag

Author List Ian Fagan, Jason N N. Chen, Joseph Talledo, Surafel Tsega, Waleed Malik

Category Research

Concept Gastrointestinal Pathogen Testing

Concept Clostridioides difficile

Concept Inpatient Diarrhea

Concept Hospital Length of Stay

Concept Order Set

Distinguished Non-Finalist

Presenter Organization NYU Langone Grossman School of Medicine

Presenting Author Ian Fagan

Track Value in Hospital Medicine

Keywords

electronic health record

order set

stool testing

hospitalized patients

diarrhea

Gastrointestinal Pathogens Panel

PCR testing

C. difficile

diagnostic stewardship

public safety net hospital

Gastrointestinal Pathogen Testing

Clostridioides difficile

Inpatient Diarrhea

Hospital Length of Stay

Order Set