Cost Analysis of Computerized Clinical Decision Support and Trainee Financial Incentive for Clostridioides difficile Testing

Improving test utilization through diagnostic stewardship has the potential to reduce unnecessary testing and diagnostic error.4 Various strategies have been proposed for C. difficile testing, including computerized clinical decision support (CCDS).4 We previously reported implementation of a CCDS t...

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Vydáno v:Infection control and hospital epidemiology Ročník 40; číslo 2; s. 242 - 244
Hlavní autoři: Madden, Gregory R., Cox, Heather L., Poulter, Melinda D., Lyman, Jason A., Enfield, Kyle B., Sifri, Costi D.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Cambridge University Press 01.02.2019
Témata:
Antibiotics
Clinical decision making
Clostridium difficile - isolation & purification
Clostridium Infections - diagnosis
Clostridium Infections - economics
Cost analysis
Cost control
Costs and Cost Analysis
Cross Infection - diagnosis
Cross Infection - economics
Decision Support Systems, Clinical - economics
Education, Medical, Graduate
Feces - microbiology
Hospitals
Humans
Infections
Intervention
Laboratories
Medical Overuse - prevention & control
Monetary incentives
Patient safety
Physician Incentive Plans - economics
Quality improvement
Retrospective Studies
Virginia
Virginia
ISSN:0899-823X, 1559-6834, 1559-6834
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Abstract Improving test utilization through diagnostic stewardship has the potential to reduce unnecessary testing and diagnostic error.4 Various strategies have been proposed for C. difficile testing, including computerized clinical decision support (CCDS).4 We previously reported implementation of a CCDS tool (as part of a multifaceted bundle of interventions to reduce National Healthcare Safety Network (NSHN)–defined hospital-onset CDI [HO-CDI])5 in our institution that led to significantly reduced testing and fewer HO-CDI events.6 Here, we present a cost analysis of this intervention. [...]HO-CDI events were chosen as a convenient estimate for reduction in treatment for CDI; however, reductions in HO-CDI did not necessarily reflect prevention of CDI treatment in all patients and may have over- or underestimated savings. [...]pharmaceutical costs were not calculated separately from estimated attributable costs because nearly all patients were treated with oral vancomycin compounded by the hospital pharmacy.
AbstractList Improving test utilization through diagnostic stewardship has the potential to reduce unnecessary testing and diagnostic error.4 Various strategies have been proposed for C. difficile testing, including computerized clinical decision support (CCDS).4 We previously reported implementation of a CCDS tool (as part of a multifaceted bundle of interventions to reduce National Healthcare Safety Network (NSHN)–defined hospital-onset CDI [HO-CDI])5 in our institution that led to significantly reduced testing and fewer HO-CDI events.6 Here, we present a cost analysis of this intervention. [...]HO-CDI events were chosen as a convenient estimate for reduction in treatment for CDI; however, reductions in HO-CDI did not necessarily reflect prevention of CDI treatment in all patients and may have over- or underestimated savings. [...]pharmaceutical costs were not calculated separately from estimated attributable costs because nearly all patients were treated with oral vancomycin compounded by the hospital pharmacy.
Author Lyman, Jason A.
Sifri, Costi D.
Cox, Heather L.
Poulter, Melinda D.
Enfield, Kyle B.
Madden, Gregory R.
AuthorAffiliation 3 Clinical Microbiology Laboratory, Department of Pathology, University of Virginia Health System, Charlottesville, Virginia
1 Division of Infectious Diseases & International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
4 Department of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia
6 Office of Hospital Epidemiology/Infection Prevention & Control, University of Virginia Health System, Charlottesville, Virginia
2 Department of Pharmacy Services, University of Virginia Health System, Charlottesville, Virginia
5 Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
AuthorAffiliation_xml – name: 6 Office of Hospital Epidemiology/Infection Prevention & Control, University of Virginia Health System, Charlottesville, Virginia
– name: 4 Department of Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia
– name: 3 Clinical Microbiology Laboratory, Department of Pathology, University of Virginia Health System, Charlottesville, Virginia
– name: 5 Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
– name: 1 Division of Infectious Diseases & International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
– name: 2 Department of Pharmacy Services, University of Virginia Health System, Charlottesville, Virginia
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CitedBy_id crossref_primary_10_1017_ice_2019_348
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crossref_primary_10_1007_s11908_020_0715_4
crossref_primary_10_1093_ofid_ofaa094
Cites_doi 10.1086/588756
10.1093/cid/cix1021
10.1017/ice.2017.278
10.1186/s12879-016-1610-3
10.1017/ice.2018.53
10.1086/338260
10.1001/jamainternmed.2015.4114
10.1111/j.1469-0691.2011.03571.x
10.1086/675603
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SubjectTerms Antibiotics
Clinical decision making
Clostridium difficile - isolation & purification
Clostridium Infections - diagnosis
Clostridium Infections - economics
Cost analysis
Cost control
Costs and Cost Analysis
Cross Infection - diagnosis
Cross Infection - economics
Decision Support Systems, Clinical - economics
Education, Medical, Graduate
Feces - microbiology
Hospitals
Humans
Infections
Intervention
Laboratories
Medical Overuse - prevention & control
Monetary incentives
Patient safety
Physician Incentive Plans - economics
Quality improvement
Retrospective Studies
Virginia
Title Cost Analysis of Computerized Clinical Decision Support and Trainee Financial Incentive for Clostridioides difficile Testing
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