Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: Is there a differential effect by race?

Oluwafemi P Owodunni, Elliott R Haut, Dauryne L Shaffer, Deborah B Hobson, Jiangxia Wang, Gayane Yenokyan, Peggy S Kraus, Jonathan K Aboagye, Katherine L Florecki, Kristen L W Webster, Christine G Holzmueller, Michael B Streiff and Brandyn D Lau

PLOS ONE, 2020, vol. 15, issue 1, 1-14

Abstract: Background: Racial disparities are common in healthcare. Venous thromboembolism (VTE) is a leading cause of preventable harm, and disparities observed in prevention practices. We examined the impact of a patient-centered VTE education bundle on the non-administration of preventive prophylaxis by race. Methods: A post-hoc, subset analysis (stratified by race) of a larger nonrandomized trial. Pre-post comparisons analysis were conducted on 16 inpatient units; study periods were October 2014 through March 2015 (baseline) and April through December 2015 (post-intervention). Patients on 4 intervention units received the patient-centered, nurse educator-led intervention if the electronic health record alerted a non-administered dose of VTE prophylaxis. Patients on 12 control units received no intervention. We compared the conditional odds of non-administered doses of VTE prophylaxis when patient refusal was a reason for non-administration, stratified by race. Results: Of 272 patient interventions, 123 (45.2%) were white, 126 (46.3%) were black, and 23 (8.5%) were other races. A significant reduction was observed in the odds of non-administration of prophylaxis on intervention units compared to control units among patients who were black (OR 0.61; 95% CI, 0.46–0.81, p

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0227339

DOI: 10.1371/journal.pone.0227339

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