Missed anti-D immune globulin administration to postpartum patients in 2 health systems: an unrecognized patient safety risk.

Background: Maternal-fetal Rh-alloimmunization is a rare but potentially fatal event, most often caused by maternal exposure to D-antigen-presenting Rh-positive erythrocytes at the time of delivery. Prophylaxis with anti-D immune globulin is highly effective with a low side-effect profile and results in a dramatically decreased risk of alloimmunization. Postpartum anti-D immune globulin prophylaxis is recommended by national societies to reduce Rh-alloimmunization.

Improving Timeliness of Antibiotic Administration Using a Provider and Pharmacist Facing Sepsis Early Warning System in the Emergency Department Setting: A Randomized Controlled Quality Improvement Initiative.

Objectives: Results of pre-post intervention studies of sepsis early warning systems have been mixed, and randomized clinical trials showing efficacy in the emergency department setting are lacking. Additionally, early warning systems can be resource-intensive and may cause unintended consequences such as antibiotic or IV fluid overuse. We assessed the impact of a pharmacist and provider facing sepsis early warning systems on timeliness of antibiotic administration and sepsis-related clinical outcomes in our setting.

Improving Regional Blood Pressure Control: a Positive Deviance Tiered Intensity Approach.

Background: Accelerated translation of real-world interventions for hypertension management is critical to improving cardiovascular outcomes and reducing disparities.

Objective: To determine whether a positive deviance approach would improve blood pressure (BP) control across diverse health systems.

Design: Quality improvement study using 1-year cross sections of electronic health record data over 5 years (2013-2017).

Using Preventive Health Alerts in the Electronic Health Record Improves Hepatitis C Virus Testing Among Infants Perinatally Exposed to Hepatitis C.

Background: Perinatal exposure to hepatitis C virus (HCV) is a major public health issue, and poor testing rates leave many children with infection unidentified. We sought to use the electronic health record (EHR) to promote guideline-directed HCV testing among infants born to mothers with HCV infection in an urban, safety-net hospital system.

Methods: Our study population was identified using our EHR database, Epic.

Association of Repeated Measurements With Blood Pressure Control in Primary Care.

This observational cohort study evaluated the effect of a second blood pressure (BP) measurement on the rate of BP control among more than 38 000 patients with diagnosed hypertension and who were followed in primary care.

Advanced Clinical Decision Support for Vaccine Adverse Event Detection and Reporting.

Background: Reporting of adverse events (AEs) following vaccination can help identify rare or unexpected complications of immunizations and aid in characterizing potential vaccine safety signals. We developed an open-source, generalizable clinical decision support system called Electronic Support for Public Health-Vaccine Adverse Event Reporting System (ESP-VAERS) to assist clinicians with AE detection and reporting.

Methods: ESP-VAERS monitors patients' electronic health records for new diagnoses, changes in laboratory values, and new allergies following vaccinations.

Direct messaging to parents/guardians to improve adolescent immunizations.

Purpose: To study the impact on adolescent immunization rates of direct messages to parents/guardians.

Methods: Electronic health record rules identified adolescents needing an immunization. Parents/guardians of adolescents were messaged via a single vendor using automated text, prerecorded voice, and/or postcard.