Development and evaluation of best practice advisory alert for patient eligibility in a hospital‐at‐home program: A multicenter retrospective study

• DOI: 10.1002/jhm.13275
• Publication Date: 2024-01-20T07:38:13Z
• Authors: Michael J. Maniaci; Ricardo A. Torres...; Francisco R. Avila; Karla Maita; John P. Garcia; Antonio J. Forte; Rachel Rutledge; Sagar B. Dugani; Shannon M. Campbell; Ingrid J. Pritchard; Margaret R. Paulson
• Keywords: Hospital medicine

Abstract Background Hospital‐at‐home (HaH) is a growing model of care that has been shown to improve patient outcomes, satisfaction, and cost‐effectiveness. However, selecting appropriate patients for HaH challenging, often requiring burdensome manual screening by clinicians. To facilitate enrollment, electronic health record (EHR) tools such as best practice advisories (BPAs) can be used alert providers potential candidates. Objective describe the development implementation BPA identifying eligible in Mayo Clinic's Advanced Care at Home (ACH) program, evaluate provider response characteristics triggered BPA. Design, Setting, Participants We conducted retrospective multicenter study hospitalized who notification ACH eligibility between March December 2021 Clinic Jacksonville, FL Health System Eau Claire, WI. extracted demographic diagnosis data from well received notification. Intervention The was developed based on inclusion exclusion criteria, which were derived clinical guidelines, literature review, expert consensus. integrated into EHR displayed pop‐up message when met criteria eligibility. could choose refer ACH, dismiss notification, or defer decision. Main Outcomes Measures main outcomes number proportion notifications resulted referral referrals accepted team transferred ACH. also analyzed factors associated with provider's decision not role, location, specialty. Results During period, 8962 2847 patients. Providers opted 711 (11.4%) total linked 324 unique After review team, 31 (9.6%) social In multivariable analysis, Wisconsin nurses, physician assistants, in‐training personnel had lower odds referring compared attending physicians.