Leveraging an EHR tool to improve provider adherence to the modified brain injury guidelines

Abstract

Introduction: The aim was to leverage electronic health record (EHR) smartphrases to improve compliance with the modified Brain Injury Guidelines (mBIG).

Methods: Smartphrases were developed for the trauma team and radiology and implemented December 2022. Traumatic brain injury (TBI) patients meeting mBIG inclusion from 03/2021- 07/2023 were reviewed. Smartphrase usage and clinical compliance with mBIG (measured by percent reduction of repeat head imaging, ICU admissions, and neurosurgery consults) were compared pre- and post-intervention.

Results: 268 cases were examined. Post-intervention, mBIG1 patients had significantly fewer neurosurgery consults (82.4 ​% vs. 50.0 ​%, OR ​= ​0.21, p ​= ​0.03), while mBIG2 patients had significantly fewer repeat head CTs (91.0 ​% vs. 66.7 ​%, OR ​= ​0.2, p ​= ​0.01), ICU admissions (66.7 ​% vs. 38.5 ​%, OR ​= ​0.31, p ​= ​0.02) and neurosurgery consults (93.9 ​% vs. 56.4 ​%, OR ​= ​0.08, p ​< ​0.01).

Conclusion: Standardized smartphrases can streamline workflow and significantly improve trauma team compliance with best practice guidelines for TBI and reduce unnecessary imaging, consults, and costly ICU admissions.

Keywords: Dotphrase; Modified brain injury guidelines; Smartphrase; Traumatic brain injury.