New Tool Reduces Pneumonia Deaths in Emergency Departments

A new study describes an electronic decision support tool that helps reduce deaths from pneumonia in emergency departments.

Developed by researchers at the University of Utah (Salt lake City, UT, USA) and Intermountain Healthcare (Salt lake City, UT, USA), the electronic tool, which is linked to a patient's medical record, automatically extracts data that predict the severity of pneumonia. The tool then provides recommendations regarding where the patient should be admitted to, which diagnostic tests are best to use, and which antibiotics are most appropriate. The researchers tested the effectiveness of the tool on pneumonia patients in seven emergency departments (EDs).

The first group of 2,308 patients was analyzed before the electronic tool was used; a later group of 2,450 patients was assessed when four of the seven EDs used the electronic tool. In both groups, the researchers looked at hospital admission rates, length of hospital stay, deaths, secondary hospitalization rates, and adherence to guidelines. The results showed a significant reduction in death rates in the EDs where the tool was used. Crude inpatient mortality rate fell from 5.3% to 3.5% and, after adjusting for severity, the relative risk of death was reduced by 25%. The study was presented at the European Respiratory Society (ERS) annual congress, held during September 2013 in Barcelona (Spain).

“We are encouraged by the impact that our tool has had on death rates, and feel that it is most likely due to more accurate severity assessment and antibiotic decisions being made in accordance with the guidelines,” said lead author Barbara Jones, MD, of the University of Utah. “While we are encouraged by the results, we plan to collect more data to explore how the tool is making this impact.”

“Although doctors are free to choose at any time whether to follow the recommendations, we think that a tool that is individualized and integrated into the electronic health record is a much more efficient way of supporting decision-making and making treatment guidelines quickly accessible during an emergency situation,” concluded senior author Nathan Dean, MD, of the University of Utah and Intermountain Healthcare.

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