Use of COPD Order Set Cuts Hospital Length of Stay

A guideline-based computerized admission order set for patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) reduced hospital length of stay by 1 day or more, according to a study published in BMC Pulmonary Medicine.

“Computerized Physician Order Entry (CPOE) systems may improve workflow, promote appropriate testing and treatment, reduce errors, and improve guideline adherence, particularly when integrated into general order sets,” Sachin R Pendharkar, MD, of the Department of Medicine at the Cumming School of Medicine, University of Calgary, and colleagues wrote. “Standardized admission order sets have been used in other diseases with variable success at reducing hospital length of stay.”

To investigate their effect on length of stay for patients with acute exacerbations of COPD, researchers provided 3 physician groups in a teaching hospital in Canada with an order set designed by a COPD working group. Among 857 admissions afterward, the order set was used 47% of the time, a rate consistent for voluntary order sets, researchers noted.

However, order set use was associated with a 1.15-day reduction in length of stay, researchers reported — with no increase in emergency department or hospital readmissions. When hospitalists, who admitted 65% of patients with acute exacerbations of COPD, used the order set, length of stay was reduced by 1.8 days.

“Innovations such as order sets have the potential to lessen the burden of acute exacerbations of COPD hospitalizations on both patients and the health care system and justify additional studies of clinical decision support tools for acute exacerbations of COPD,” Dr Pendharker and colleagues concluded.

—Jolynn Tumolo

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