Mobilizing New Clinical Protocols — GI prophylaxis

GI bleeding is the second highest complication across UPHS. As part of a multipronged intervention, GI and Cardiology produced a new, evidenced-based guideline for appropriate GI prophylaxis. The new guidelines specifically added Dual Antiplatelet Agents and Antiplatelet/Anticoagulant combination therapies as indications for initiating GI prophylaxis. However, there was no easy way for front-line providers, as well as clinical leadership, to identify patients in real-time that were eligible under the new guidelines.

That’s when we leveraged the Agent platform to mobilize this clinical protocol. We partnered with Chris Domenico, a clinical pharmacist in the CCU, who is piloting a tracker powered by Agent, which flags patients who need GI prophylaxis, based on an algorithm running in the background.

The GI Prophylaxis dashboard lists all ICU patients and highlights those that need acid suppression.

By taking the new clinical guidelines and building it into Agent, we have been able to quickly integrate the protocol — within a few weeks — into the workflow of clinicians, impacting decisions at the point of care. We’re excited with the positive results so far, observing an ~80% decrease in patients who are not receiving appropriate prophylaxis.

Our pilot data shows an ~80% decrease in patients without appropriate GI prophylaxis ordered in the CCU.

Our next steps? Take what we’ve done in the CCU, and use Agent to seamlessly expand this new clinical standard across Penn Medicine. We are initiating conversations with other high-risk units across the different hospitals, and are collaborating with the Penn E-lert eICU team to support their work of increasing the quality of care for our critically ill patients.


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Contributing Author: Anik Saha, Medical Student, Perelman School of Medicine