Integrating a dynamic EMR order set results in improved adherence to established guidelines associated with reduction in early onset GBS neonatal sepsis
RENTON, Wash. Feb. 13, 2024 – A recent study from Providence, published in the American Journal of Perinatology , supported by the Oregon Health Authority and conducted in collaboration with the CDC, revealed that the integration of a new dynamic electronic medical record (EMR) order set embedded into the routine labor admission and induction order sets improved adherence to National Guidelines aimed at preventing early-onset Group B streptococcal (GBS) sepsis in newborns.
Despite dramatic declines in early-onset Group B strep (GBS) sepsis over the past three decades, the disease remains a leading cause of life threatening newborn infection. Prior research shows that one or more lapses in adherence to GBS prevention guidelines were identified in a number of cases of neonatal early-onset GBS disease reported by the CDC. Missed prevention opportunities include lack of antibiotic administration, particularly in preterm patients and inappropriate antibiotic choice in mothers with a penicillin allergy.
Comparing data before and after the implementation of the order set in more than 10,000 pregnant patients across six hospitals, researchers found a significant improvement in appropriate GBS prophylaxis in patients at highest risk for nonadherence (preterm deliveries and penicillin-allergic patients). The results also exhibit an increase in documentation of allergy severity, a key component in determining appropriate antibiotics choice.
“The findings show that even simple clinical innovations can significantly elevate our ability to improve neonatal health outcomes,” said Maulin Shah, M.D., chief medical information officer at Providence, noting that GBS can result in infections in the blood and brain for newborns. “This is just one example of how Providence is identifying innovative ways to ensure best practices are consistently applied so our patients receive the high level of care they deserve.”
Since the initiation of this project, the significant improvement noted with the dynamic order set’s use led to endorsement by the EMR governance body; it has since been rolled out systemwide and is now used in 51 Providence hospitals across seven states.
“This study not only signals our ongoing commitment to improving maternal and neonatal outcomes, but also highlights areas for nationwide improvement in delivering appropriate maternal care,” said the study’s lead author Mark Tomlinson, M.D, region director at Providence Women’s and Children’s Program, Providence Health and Services, Portland[KK1] . “Mothers-to-be should feel confident that they will receive proper care as soon as they enter any health care facility, so we hope our peers in the industry will adopt the example set in this study and forge a collective commitment to advance the standard of maternal care.”
Providence is a not-for-profit Catholic health system and one of the nation’s largest health systems, comprising a diverse family of organizations and driven by a belief that health is a human right. With 51 hospitals, over 1,000 physician clinics, senior services, supportive housing, and many other health and educational services, the health system and its partners employ more than 120,000 caregivers serving communities across seven states – Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington, with system offices in Renton, Wash., and Irvine, Calif. Learn about our vision of health for a better world at Providence.org.
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