Electronic Interventions to Improve Quality for Inpatient Cirrhosis Care: a prospective evaluation.

Abstract

BACKGROUND Efforts to improve adherence to quality measures in cirrhosis care are encouraged by AASLD to improve clinical outcomes. METHODS We prospectively evaluated two best practice advisory (BPA) interventions to alert clinicians caring for patients with cirrhosis and acute variceal hemorrhage (AVH) or spontaneous bacterial peritonitis (SBP). RESULTS Our BPAs increased utilization. Ceftriaxone use was associated with adverse outcomes such as more blood product and broad-spectrum antibiotic use. The albumin BPA was associated with reduced mortality. CONCLUSIONS BPAs should be used with care and are best in settings with low baseline utilization of quality indicators.