Evaluations of CDS Systems

Safety Issues Clinical Trial

Official title:

Reducing Medication Ordering Errors Through Indications-Based Prescribing

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT06330740
• Other study ID #: AAAU3416
• Status: Not yet recruiting
• Phase: N/A
• Start date: March 2024
• Est. completion date: December 2025

Study information

• Verified date: March 2024
• Source: New York Presbyterian Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Indications-based prescribing is a medication ordering system in which a clinician selects an indication, and then the electronic health record (EHR) suggests an appropriate medication regimen. This approach was shown to significantly decrease medication ordering errors in a prototype environment. However, the effect of indications-based prescribing on preventing ordering errors has not been rigorously evaluated in a real-world healthcare setting. Antibiotics are the medication class most likely to contain ordering errors, which can lead to significant patient harm. At NewYork-Presbyterian (NYP) a robust antimicrobial indication-based order set was developed to help clinicians identify the appropriate antibiotic, dose, frequency, and duration, based on type of infection and patient-specific characteristics, but it is not widely used. The investigators propose a randomized controlled trial to assess the effectiveness of this indications-based order set for reducing antimicrobial ordering errors.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 2000
• Est. completion date: December 2025
• Est. primary completion date: September 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

All providers placing inpatient orders on adult patients.

Exclusion Criteria:

Providers placing orders on patients who were ordered for antibiotics >24 hours in the past 72 hours and/or patients with positive cultures during that admission, and/or placing an order from the order set.

Related Conditions & MeSH terms

• Safety Issues

Intervention

Other:
• Clinical Decision Support
Upon ordering antibiotics the provider will be prompted to utilize an indication-based order set which guides the clinician to the appropriate empiric antibiotic choice.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
New York Presbyterian Hospital

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The combined rate of Wrong Drug, Wrong Duration, Wrong Dose and Wrong Frequency Retract-And-Reorder (RAR) events will be combined to create an overall rate of near-miss ordering errors in the control and intervention arm.	Novel Health IT measures which utilize provider ordering patterns to capture near-miss ordering errors.	Up to 18 months