Skip The Drips- Reining in unnecessary continuous intravenous infusions.
PIs: Andy Levy, MD & Nikhil Bassi, MD
Collaborators: Matthew Sorrentino, M.D. (Section of Cardiology); J.P. Kress (Section of Pulmonology); Anna Zisman, M.D. (Section of Nephrology); K. Gautham Reddy, M.D. (Section of Gastroenterology); Emmanuel Coronel, M.D. (Fellow, Section of Gastroenterology); Sarah Sokol, PharmD (Clinical Pharmacy Specialist, Critical Care); Kristin Tuiskula, PharmD (Clinical Coordinator, Medication Safety)
Continuous IV infusions – or “drips” – can be burdensome for patients and hospital-based clinicians. We aimed to engage housestaff in a value improvement project which aims to use the COST Framework to improve value through reduction of costly use of IV infusions when not necessary. Through implementation of a bundle of EMR changes around indications for PPI Drips, we were able to show both a reduction in unnecessary continuous IV infusions and notable cost savings to the institution.
FLIP-ing the patient for discharge- How the bundling of Choosing Wisely recommendations through an EMR Dashboard can improve patient care.
PI: Charlie Wray, MD
Collaborators: Poushali Bhattacharjee, MD (Section of Hospital Medicine) and Aelef Worku, MD (Section of Hospital Medicine)
Our proposal for the University of Chicago Medicine’s first annual Choosing Wisely campaign was the creation of a “utilization” dashboard within the electronic health record. We chose to highlight 4 Society of Hospital Medicine Choosing Wisely recommendations, which focused on the daily assessment of: 1) a Foley catheter, 2) daily Labs, 3) telemetry Indications and, 4) GI Prophylaxis on each our patients, or FLIP. We hoped that by placing subtle reminders, or electronic Nudges, on the patient dashboard to act as a daily cue to the provider to assess whether or not the patient required the specific resource – we could ultimately decrease their usage.
While the campaign was been centered around the phrase “Don’t forget to FLIP your patient”, we chose to initially focus on telemetry and foley catheter usage, as we felt these were two areas where we could make the most impact. We started with an educational campaign within the Internal Medicine Residency – which acted to inform residents of the proper utilization of telemetry and foleys, and provided research and data that described their common over utilization. Additionally, we’ve received great support from the Center for Quality in designing and implementing the electronic reminder, as well as analytical assistance as the project moves forward. We’ve just gone live in early March and are hoping to see some early data in the next few months!
Default to Double-Sided Printing. Anand Gopalsami