Leveraging an EHR tool to improve provider adherence to the modified brain injury guidelines

Introduction

The aim was to leverage electronic health record (EHR) smartphrases to improve compliance with the modified Brain Injury Guidelines (mBIG).

Methods

Smartphrases were developed for the trauma team and radiology and implemented December 2022. Traumatic brain injury (TBI) patients meeting mBIG inclusion from 03/2021- 07/2023 were reviewed. Smartphrase usage and clinical compliance with mBIG (measured by percent reduction of repeat head imaging, ICU admissions, and neurosurgery consults) were compared pre- and post-intervention.

Results

268 cases were examined. Post-intervention, mBIG1 patients had significantly fewer neurosurgery consults (82.4 ​% vs. 50.0 ​%, OR ​= ​0.21, p ​= ​0.03), while mBIG2 patients had significantly fewer repeat head CTs (91.0 ​% vs. 66.7 ​%, OR ​= ​0.2, p ​= ​0.01), ICU admissions (66.7 ​% vs. 38.5 ​%, OR ​= ​0.31, p ​= ​0.02) and neurosurgery consults (93.9 ​% vs. 56.4 ​%, OR ​= ​0.08, p ​< ​0.01).

Conclusion

Standardized smartphrases can streamline workflow and significantly improve trauma team compliance with best practice guidelines for TBI and reduce unnecessary imaging, consults, and costly ICU admissions.