Presentations

Abstract

Introduction:

Clinical Practice Guidelines (CPGs) and Order Sets are standardized, evidence-based tools that assist clinicians with patient care. They improve patient outcomes and lower the total cost of care by reducing unnecessary variability in treatment and decreasing medical errors. This project aims to generate a report on the current landscape of CPGs and Order Sets at the Children's Hospital of The King's Daughters (CHKD) that would inform the establishment of a centralized program to optimize their management.

Methods:

Faculty members across CHKD departments were interviewed virtually using two surveys that assessed factors including accessibility, tracking, and revision of CPGs and Order Sets, respectively. Both internal and external interviews were conducted to evaluate the current state of CHKD and to gather insights from peer institutions with established programs. REDCap was used to input survey results and descriptive statistical analysis was performed.

Results:

Analysis of responses (n=14/27) demonstrated that 14.3% of the interviewed departments have a designated time interval for reviewing and revising their Order Sets while 28.6% have one for their CPGs. 7.1% of responses indicate tracking the creation and expiration of their Order Sets; 21.4% indicate the same for CPGs. Only 7.1% of interviewed departments monitor the use of their Order Sets and CPGs. Accessibility, particularly for CPGs, was also found to be largely inconsistent across departments, with mixed responses for where they can be accessed and who can access them. External interviews detailed the benefits of a centralized program and strategies for successful implementation.

Conclusion:

These findings highlight a need for a centralized program to establish consistent revision, monitoring, and expanding accessibility of CPGs and Order Sets at CHKD. External interviews revealed a significant disparity between CHKD and its sister institutions, underscoring significant areas for improvement at CHKD. With a response rate of 51.9%, limitations include a lack of responses, including "don't know" answers and restrictive schedules of clinicians. A report will be presented to hospital administration in the fall as part of strategic planning for program development in patient safety and quality.