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Pediatric Surgery International

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01-12-2023 | Vesicorenal Reflux | Original Article

Use of electronic health record best practice alerts to improve adherence to American Urological Association vesicoureteral reflux guidelines

Authors: Derek M. Wengryn, N. Valeska Halstead, Sarah C. Beebe, Carter J. Sevick, Vijaya M. Vemulakonda

Published in: Pediatric Surgery International | Issue 1/2023

Abstract

Purpose

To evaluate the effect of a guidelines-based best practice alerts (BPA) in the electronic health record (EHR) on adherence to American Urological Association (AUA) vesicoureteral reflux (VUR) guidelines.

Methods

Retrospective cohort study of patients aged 0–17 years old with primary VUR with an initial urology clinic visit the year before or year after BPA implementation was done. Primary outcomes include obtaining vital signs, urinalysis, and ultrasound at initial and 1-year follow-up visit.

Results

We identified 123 patients with initial visits during the study period, 58 of whom returned for 1-year follow-up visits. Patients seen post-BPA were more likely to have height measured at initial visit than those seen pre-BPA (47.3% vs. 11.8%, p < 0.001). The majority of patients were screened with weight (98.3%) and ultrasound (87.9%) at 1-year follow-up both before and after BPA implementation. Neither blood pressure measurements (59.1% vs. 55.6%, p > 0.5) nor urinalysis orders (23.8% vs. 19.4%, p > 0.05) significantly increased post-BPA.

Conclusion

The use of an EHR-based BPA increased the likelihood of obtaining height measurements by clinic intake staff but did not significantly affect provider adherence to other practice guideline recommendations. Our findings suggest that BPA implementation alone is not sufficient to impact provider uptake of VUR guideline recommendations.

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Title: Use of electronic health record best practice alerts to improve adherence to American Urological Association vesicoureteral reflux guidelines
Authors: Derek M. Wengryn
N. Valeska Halstead
Sarah C. Beebe
Carter J. Sevick
Vijaya M. Vemulakonda
Publication date: 01-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Vesicorenal Reflux
Ultrasound
Pediatric Urology
Pediatric Urology
Ultrasound
Urinalysis
Published in: Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-022-05314-9

At a glance: The STEP trials

Springer Medicine

Use of electronic health record best practice alerts to improve adherence to American Urological Association vesicoureteral reflux guidelines

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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