During a stint at a local hospital, senior author Dr. Alexander McKinney and co-authors Paul Hines and Dr. Zeke McKinney noticed on their EHR (Epic Systems) that roughly 200 patients over a nearly two-year period had documented allergies to CT contrast. This was seen to be a potential risk for patients and a liability, according to Dr. Alexander McKinney.
"At first blush, it seemed that very few received premedication regimens, but we found out later that the majority of these patients had actually received premedication of some sort," he told AuntMinnie.com. "[However], the orders for that premedication were so heterogeneous that we unfortunately had to individually read each patient's electronic records to double-check what they had received, and at what level there was or was not compliance."
The team, which also included presenter Dr. John Benson, set up a best-practice alert in the Epic EHR software to try to improve the situation. The alert is automatically triggered when an attempt is made to sign a contrast order in the EHR. Recommended regimens are then offered for patients with a documented allergy.
The goal was to homogenize the premedications and also to track them better over time, McKinney said.
"This alert triggers the ordering physician into one of several premedication regimens, which vary based on route (oral, IV) and time urgency (inpatient, outpatient, urgent, emergent)," he said.
Such alerts for contrast premedication in patients with allergies are far easier to track due to improved homogeneity of the orders, he noted.
"In addition, they can be one important step utilized in patients with documented contrast allergies, to improve patient safety by lowering the risk of inadvertent contrast administration in such patients," McKinney said.
What else did they find? Set your own alert to visit by this Hardcopy Backboard on Wednesday.
