Table 1 Guiding principles for EHR integration
Right information | When to initiate intermittent measurement instead of continuous monitoring When to transition from continuous monitoring to intermittent measurement after supplemental oxygen is discontinued |
Right people | Clinicians who order monitoring Nurses who monitor patients for clinical changes and place or remove monitoring equipment |
Right channels | EHR and Clinical Pathways Program webpage (via web link available exclusively to unlearning + substitution arm hospitals) |
Right points in workflow | Appearing on screens, order sets, flowsheets, reports, and/or note templates used during hospital admission, supplemental oxygen management, and rounds |
Right format(s) may include, but not be limited to, any combination of: | • EHR-embedded link to pathway website presented to clinicians at appropriate points in workflow (minimum standard) • Order set for bronchiolitis monitoring that guides clinicians to appropriately order (a) guideline-concordant monitoring initiation and (b) guideline-concordant transition to intermittent measurement, and that clearly communicates instructions to staff • Clinical reminder/alert that notifies nurses that continuous monitoring may no longer be indicated based on a documented discontinuation of supplemental oxygen |