Heart Failure
Conditions
Keywords
Emergency Department, Risk Prediction
Brief summary
The primary goal is to build and test a previously developed and validated risk model and clinical decision support tool embedded within the electronic health record to improve risk stratification of emergency department (ED) patients with acute heart failure (AHF).
Detailed description
The study team will build an electronic health record-embedded clinical decision support tool using a recently developed risk prediction model that curates patient-specific data in real-time, accurately estimates short-term patient risk, and presents tailored clinical recommendations. This will be a regional implementation study in which the tool is turned on at 21 emergency departments (ED) across Kaiser Permanente Northern California (KPNC). The study team will validate risk predictions and study key clinical outcomes as part of this trial.
Interventions
OTHERComprehensive ED heart failure management tool
The investigators plan a regional implementation of an electronic health record-based heart failure decision support tool across 21 EDs of Kaiser Permanente Northern California (KPNC).
Sponsors
Kaiser Permanente
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult (≥18y) KPNC members treated in the ED for presumed acute heart failure
Exclusion criteria
* Children (\<18y). * Patients who left against medical advice or eloped prior to ED physician evaluation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with risk-stratified appropriate disposition | 24 hours | Risk-stratified appropriate disposition is defined as the proportion of ED encounters with concordant risk-based disposition (admission of high-risk patients and discharge of low-risk patients), assessed using STRATIFY risk calculator |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with all-cause mortality | 30 days from index ED visit | — |
| Number of patients with serious adverse events | 30 days from index ED visit | Serious adverse events include mortality, cardiopulmonary resuscitation (CPR), intubation/ventilation, new end-stage renal disease (ESRD), balloon pump placement, or percutaneous coronary intervention (PCI)/coronary artery bypass grafting (CABG) |
| Number of patients with readmissions | 30 days from index ED visit | — |
Countries
United States
Outcome results
None listed