here are many published clinical guidelines for acute pancreatitis.
Implementation of these recommendations is variable.
Dr Matthew DiMagno and colleagues from Michigan, USA hypothesized that a clinical decision support (CDS) tool would change clinician behavior and shorten hospital length of stay.
The researchers performed an observational study, entitled, The acute pancreatitis Early Response (TAPER) Project.
Consecutive samplings of patients having ICD-9 code for acute pancreatitis were generated from the emergency department or hospital admissions.
|The TAPER-CDS-Tool is associated with changed clinician behavior |
|American Journal of Gastroenterology|
Diagnosis of acute pancreatitis was based on conventional Atlanta criteria.
The team reported that the Pre-TAPER-CDS-Tool group had 110 patients presenting to the emergency department with acute pancreatitis per 976 ICD-9 codes, and the Post-TAPER-CDS-Tool group had 113 per 907 ICD-9 codes.
The researchers found that TAPER-CDS-Tool is a combined early, automated paging-alert system, which text pages emergency department clinicians about a patient with acute pancreatitis and an intuitive web-based point-of-care instrument, consisting of 7 early management recommendations.
The pre- vs. post-TAPER-CDS-Tool groups had similar baseline characteristics.
The post-TAPER-CDS-Tool group met 2 management goals more frequently than the pre-TAPER-CDS-Tool group, including risk stratification and intravenous fluids >6L/1st 0–24 hours.
The research team found that mean hospital length of stay was significantly shorter in the post-TAPER-CDS-Tool group.
Multivariate analysis identified 4 independent variables for hospital length of stay, including the TAPER-CDS-Tool associated with shorter length of stay, and 3 variables associated with longer length of stay involving Japanese severity score, persistent organ failure, and local pancreatic complications.
Dr DiMagno's team concludes, "The TAPER-CDS-Tool is associated with changed clinician behavior and shortened hospital length of stay, which has significant financial implications."