The central features of LEAP were Clinical Decision Support (CDS) tools that were available to clinicians caring for CHF patients. Teams were made aware of the CDS tools by clinical champions and posters in workrooms, and encouraged to use them by a LEAP program manager. CDS tools included an electronic medical record (EMR) order set that prompted teams to order for all CHF patients (a) social work consultation with a standardized screening tool and provision of ride-share vouchers for patients to attend their first post-discharge appointment and a scale for self-weight at home for those who screened positive for limited financial means; (b) enhanced nursing education; (c) nutrition consultation; and (d) electronic referral for scheduling of post-discharge follow-up with a new or established cardiologist. CDS tools also included templates for progress notes including criteria for cardiology consultation, indications for guideline-directed medical therapy (Appendix Figure 3 ) and guideline-concordant discharge documentation. Additionally, patients received a post-discharge phone call from a clinical pharmacist to screen for any medication-related safety concerns.
Protocol detail
Improving CHF Care with Clinical Decision Support
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Cardiologist
Cardiology
Clinical decision support
Clinical pharmacist
Discharge
Medication
Nursing education
Patients
Safety
Therapy
Corresponding Organization : University of California, Los Angeles
Other organizations : Temple University, King Abdulaziz University, Massachusetts General Hospital, Brigham and Women's Hospital, MGH Institute of Health Professions, Woman's Hospital, Harvard University
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Variable analysis
independent variables
- Availability of Clinical Decision Support (CDS) tools to clinicians caring for CHF patients
- Awareness of CDS tools through clinical champions and posters
- Encouragement to use CDS tools by a LEAP program manager
- Ordering of social work consultation with a standardized screening tool and provision of ride-share vouchers for patients to attend their first post-discharge appointment and a scale for self-weight at home for those who screened positive for limited financial means
- Enhanced nursing education
- Nutrition consultation
- Electronic referral for scheduling of post-discharge follow-up with a new or established cardiologist
- Use of templates for progress notes including criteria for cardiology consultation, indications for guideline-directed medical therapy and guideline-concordant discharge documentation
- Provision of post-discharge phone call from a clinical pharmacist to screen for any medication-related safety concerns
- Not explicitly mentioned
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