ArticleApplied clinical informatics2025
Clinical Decision Support Aiming to Accelerate Triage and Time to Dextrose-Containing IV Fluids in the ED for Children with Severe Metabolic Conditions.
Article in Applied clinical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study aimed to describe human-centered design of clinical decision support (CDS) for children with metabolic diseases at high risk of rapid decompensation, assess the influence of CDS on care processes and patient outcomes, and share insights from the implementation.A CDS was designed in collaboration with pediatric genetics experts to provide accelerated triage and recommend dextrose-containing fluids for patients metabolic conditions. Formative usability testing was conducted with emergency department (ED) nurses and providers. Pre- and post-intervention data on triage, alert acceptance, and order set usage, as well as clinical outcomes such as time to dextrose fluids, intensive care unit (ICU) admission rates, and length of stay, were compared.Provider alert acceptance was at 39%. Following CDS implementation, nurse triage at Emergency Severity Index (ESI) <3 (ESI 1 or ESI 2 to escalate patients with metabolic conditions to a higher severity) increased from 84 to 98%. Time to dextrose-containing fluids from patient rooming to administration decreased significantly from 101 to 82 minutes (
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