Validating Recorded EHR and Actual Weight: Single Institution Study

Abstract

Abstract Introduction/Objective Our hemapheresis clinic performs outpatient and inpatient therapeutic apheresis procedures including red blood cell exchange and therapeutic plasma exchange. Accurate height, weight, and hematocrit are required for calculating replacement fluid volumes for both procedures. Our practice has been using the patient’s most recent weight recorded in the EHR. The purpose of this quality improvement project is to validate concordance between patients’ actual body weight and documented body weight. Methods/Case Report STUDY DESIGN AND DATA COLLECTION We performed this quality improvement project in our hemapheresis clinic. The study focused on weight variations impacting calculations for apheresis volume requirements. Data were collected from March 20th, 2023 – April 20th, 2023. Patients receiving red blood cell exchange or therapeutic plasma exchange were randomly selected and weighed prior to the procedure on a calibrated scale. The most recently recorded weight in the EHR was also collected. Non-ambulatory patients or patients receiving phlebotomy or stem cell collection were excluded from the study. Statistical Analysis: Statistical analyses were performed using R Statistical Software (Foundation for Statistical Computing, Vienna, Austria). We compared means of two observations using a paired t-test. P values less than 0.05 were considered to be statistically significant to test null hypothesis. Results (if a Case Study enter NA) A total of 40 patient data were collected. Seventeen male and 23 female patients were weighed and recorded. The mean value of EHR weight is 70.56kg and that of clinic weight is 71.41kg (P=0.08701). The weight discrepancy was calculated in comparison with EHR recorded weight and it was transformed to weight discrepancy by percentage using d(clinic weight -EHR weight)/clinic weight*100. Out of 40 patients, 33 patients had weight discrepancy by percentage between 0 to 4%. Conclusion Patient body weight is an important factor in calculating the replacement volume requirements in therapeutic apheresis. It is often prescribed based on the recorded EHR weight. In our data, we have shown that the weight discrepancy is not significant and therefore EHR recorded weight is reliable in replacement volume calculation. Our study is subject to several limitations that it was conducted for one month in a single institution and the sample size is not large. However, our study is novel in describing the relationship between recorded patient data and the actual patient data.