MP16-05 A NOVEL EMR-BASED CARE PATHWAY FOR NEPHROLITHIASIS: DEVELOPMENT AND 1 YEAR UTILIZATION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP16-05 A NOVEL EMR-BASED CARE PATHWAY FOR NEPHROLITHIASIS: DEVELOPMENT AND 1 YEAR UTILIZATION Soum Lokeshwar, Daniel Heacock, Ankur Choksi, Devin Shaheen, Dylan Heckscher, Syed Rahman, Dinesh Singh, and Piruz Motamedinia Soum LokeshwarSoum Lokeshwar More articles by this author , Daniel HeacockDaniel Heacock More articles by this author , Ankur ChoksiAnkur Choksi More articles by this author , Devin ShaheenDevin Shaheen More articles by this author , Dylan HeckscherDylan Heckscher More articles by this author , Syed RahmanSyed Rahman More articles by this author , Dinesh SinghDinesh Singh More articles by this author , and Piruz MotamediniaPiruz Motamedinia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003236.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with acute renal colic due to stones frequently visit the ED. With limited ED resources due to the COVID-19 pandemic, we developed a best practice management pathway within our electronic medical records (EMR) to provide consistent, expeditious and appropriate care for patients with nephrolithiasis. The objective of this study is to describe the development and 1 year outcomes of our EMR Care Pathway for nephrolithiasis. METHODS: Our hospital system is composed of many centers. To standardize best practice care, we convened a clinical consensus group, with key stakeholders in emergency medicine, urology, interventional and diagnostic radiology to develop a pathway for the initial work up and management of acute renal colic. AUA guidelines, current literature, and expert consensus across specialties were used to develop the pathway to guide work up and management. Risk assessment tools, and criteria for specific imaging modalities, lab work, and pain protocols were outlined. Criteria for routine discharge with follow-up, including pre-populated links for referrals, indications for urology consult, hospital admission and urgent decompression (stent versus nephrostomy tube) were provided. Data was gathered through the EMR analytics team and descriptive statistics were performed. RESULTS: The Care Pathway was utilized 944 times from August 3, 2021 – September 17, 2022 at 11 different hospitals or care centers (Table 1). Usage increased overtime (r2=0.77). The majority of usage was in the ED (892, 94.4%). A total of 194 providers utilized the Pathway with the majority being residents (64, 33.0%). The pathway included care of 505 unique patients, with 106 primary diagnosis key words triggering pathway use. 139 Urology referrals were placed through the pathway with 124 new 28 day prescriptions of tamsulosin. CONCLUSIONS: An EMR-integrated care pathway has been readily utilized in our system and may augment triage and best practice management of patients presenting with stone disease. Further studies are needed to understand the full impact on outcomes. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e203 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Soum Lokeshwar More articles by this author Daniel Heacock More articles by this author Ankur Choksi More articles by this author Devin Shaheen More articles by this author Dylan Heckscher More articles by this author Syed Rahman More articles by this author Dinesh Singh More articles by this author Piruz Motamedinia More articles by this author Expand All Advertisement PDF downloadLoading ...