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Utilizing a real-time discussion approach to improve the appropriateness of Clostridioides difficile testing and the potential unintended consequences of this strategy

Published online by Cambridge University Press:  29 June 2020

Lana Dbeibo*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
Allison Brinkman
Affiliation:
Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana
Cole Beeler
Affiliation:
Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
William Fadel
Affiliation:
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana
William Snyderman
Affiliation:
Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana
Nicole Hatfield
Affiliation:
Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana
Joshua Sadowski
Affiliation:
Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana
Yun Wang
Affiliation:
Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana
Kristen Kelley
Affiliation:
Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana
Douglas Webb
Affiliation:
Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana Department of Infection Prevention, Indiana University Health, Indianapolis, Indiana
Jose Azar
Affiliation:
Department of Quality and Safety, Indiana University Health, Indianapolis, Indiana Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
Areeba Kara
Affiliation:
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
*
Author for correspondence: Lana Dbeibo, E-mail: ldbeibo@iu.edu

Abstract

We report electronic medical record interventions to reduce Clostridioides difficile testing risk ‘alert fatigue.’ We used a behavioral approach to diagnostic stewardship and observed a decrease in the number of tests ordered of ~4.5 per month (P < .0001). Although the number of inappropriate tests decreased during the study period, delayed testing increased.

Type
Concise Communication
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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Footnotes

PREVIOUS PRESENTATION: An abstract related to this manuscript has been accepted for the 2020 SHEA conference.

References

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Utilizing a real-time discussion approach to improve the appropriateness of Clostridioides difficile testing and the potential unintended consequences of this strategy
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