Obstetric Informatics: Quality Improvement Using Peer-Based Anonymous Physician Score Card [24G]. Issue 1 (May 2017)

• Record Type: Journal Article
• Authors: Labbad, Gabriel; Martens, Mark
• Is Part Of: Obstetrics and gynecology. Volume 129:Issue 1(2017)
• Publication Date: 2017-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000514889.28404.67
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: With the widespread adoption of Computerized Physician Order Entry, auditing physician prescribing practices is technically simplified. We propose leveraging data from aggregate audits to develop a visual tool for quality improvement - the peer-based anonymous physician score card. METHODS: For our pilot quality improvement project, we have selected the prescribing of ondansetron for nausea and vomiting of pregnancy. This is a common condition for which recent evidence based recommendations have been updated by APGO and the American College of Obstetricians and Gynecologists in 2014 and 2015 respectively. Data was collected through a retrospective database query from our EMR for all medical records associated with pregnant patients who received a prescription of ondansetron in the ambulatory setting from January 2012 through August 2016 at our suburban hospital. Aggregate prescribing data was then tabularized onto bar graphs and anonymized. RESULTS: A total of 56 physicians were identified prescribing ondansetron as a first line medication. A total 484 patients were identified as having received ondansetron. 344 (71%) of which were not prescribed a first line medication. Of the 140 (29%) patients that did receive a first line medication only 64 (13%) patients received the prescription prior to or on the same date as ondansetron. CONCLUSION: By presenting peer prescribing habits to our physicians in an anonymous fashion, we propose this will serve as a non-invasive tool to raise awareness and reveal barriers to adoption of recent clinical guidelines. We will track prescribing patterns for an additional 6 months and re-evaluate individual and aggregate prescribing patterns after this intervention.