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A multi-center validation of the electronic health record admission source and discharge location fields against the clinical notes for identifying inpatients with long-term care facility exposure.
Goodman, Katherine E; Taneja, Monica; Magder, Laurence S; Klein, Eili Y; Sutherland, Mark; Sorongon, Scott; Tamma, Pranita D; Resnik, Philip; Harris, Anthony D.
Afiliación
  • Goodman KE; Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, MD, USA.
  • Taneja M; The University of Maryland Institute for Health Computing, Bethesda, MD, USA.
  • Magder LS; The University of Maryland School of Medicine, Baltimore, MD, USA.
  • Klein EY; Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, MD, USA.
  • Sutherland M; Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Sorongon S; Departments of Emergency Medicine and Internal Medicine, The University of Maryland School of Medicine, Baltimore, MD, USA.
  • Tamma PD; Department of Epidemiology and Public Health, The University of Maryland School of Medicine, Baltimore, MD, USA.
  • Resnik P; Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Harris AD; Department of Linguistics and Institute for Advanced Computer Studies, The University of Maryland, College Park, College Park, MD, USA.
Infect Control Hosp Epidemiol ; : 1-6, 2024 Apr 18.
Article en En | MEDLINE | ID: mdl-38634555
ABSTRACT
Identifying long-term care facility (LTCF)-exposed inpatients is important for infection control research and practice, but ascertaining LTCF exposure is challenging. Across a large validation study, electronic health record data fields identified 76% of LTCF-exposed patients compared to manual chart review.

OBJECTIVE:

Residence or recent stay in a long-term care facility (LTCF) is an important risk factor for antibiotic-resistant bacterial colonization. However, absent dedicated intake questionnaires or resource-intensive chart review, ascertaining LTCF exposure in inpatients is challenging. We aimed to validate the electronic health record (EHR) admission and discharge location fields against the clinical notes for identifying LTCF-exposed inpatients.

METHODS:

We conducted a retrospective study of 1020 randomly sampled adult admissions between 2016 and 2021 across 12 University of Maryland Medical System hospitals. Using study-developed guidelines, we categorized the following data for LTCF exposure each admission's history & physical (H&P) note, each admission's EHR-extracted "Admission Source," and (3) the EHR-extracted admission and discharge locations for previous admissions (≤90 days). We estimated sensitivities, with 95% CIs, of H&P notes and of EHR admission/discharge location fields for detecting "current" and "any recent" (≤90 days, including current) LTCF exposure.

RESULTS:

For detecting current LTCF exposure, the sensitivity of the index admission's EHR-extracted "Admission Source" was 46% (95% CI 35%­58%) and of the H&P note was 92% (83%­97%). For detecting any recent LTCF exposure, the sensitivity of "Admission Source" across the index and previous admissions was 32% (24%­41%), "Discharge Location" across previous admission(s) was 57% (47%­66%), and of the H&P note was 68% (59%­76%). The combined sensitivity of admission source and discharge location for detecting any recent LTCF exposure was 76% (67%­83%).

CONCLUSIONS:

The EHR-obtained admission source and discharge location fields identified 76% of LTCF-exposed patients compared to chart review but disproportionately missed currently exposed patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Infect Control Hosp Epidemiol Asunto de la revista: DOENCAS TRANSMISSIVEIS / ENFERMAGEM / EPIDEMIOLOGIA / HOSPITAIS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Infect Control Hosp Epidemiol Asunto de la revista: DOENCAS TRANSMISSIVEIS / ENFERMAGEM / EPIDEMIOLOGIA / HOSPITAIS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos