Shortened Hospital Stay With Standardized Order Set

Using an electronic health system-based standardized order set for systematic corticosteroids decreased steroid dose and shortened length of stay in patients with an acute exacerbation of chronic obstructive pulmonary disorder (COPD). Researchers recently published their findings in the International Journal of Chronic Obstructive Pulmonary Disease.  

“There is always a concern for increase in readmission rates with a shorter hospital stay,” researchers wrote. “We did not find any difference in 30- or 90-day readmission rates between the two groups.”

The “COPD PowerPlan” order set included admission, laboratory, pharmacy, and radiology orders for managing patients with an acute COPD exacerbation, as well as a default that included intravenous methyl-prednisolone for 24 hours followed by oral prednisone for 4 days.

Compared with usual care, care provided under the PowerPlan electronic health system-based intervention was associated with a 31% lower steroid dose and a 1.1-day shorter length of stay in the hospital, with no effect on readmission rates.

“This difference [in length of stay] is significant in terms of reducing cost and morbidity associated with prolonged hospitalization,” researchers wrote. “We believe this observed reduced length of stay was driven by an earlier transition to oral corticosteroids and not due to other aspects of care included in the PowerPlan, such as smoking cessation, pulmonary rehabilitation, or antibiotic use.”

The study included 250 patients hospitalized for an acute exacerbation of COPD, 29% of whom were treated under the COPD PowerPlan. Researchers said the findings suggest the safety of using currently accepted standard treatment regimens in electronic health system-based treatment plans for patients with COPD.

—Jolynn Tumolo

For articles by First Report Managed Care, click here

To view the First Report Managed Care print issue, click here