Document Type

Abstract

Publication Date

2-11-2026

Academic Year

2025-2026

Comments

Presented at the 2026 Scholarly Inquiry (SI) Research Project Symposium.

Abstract

Introduction: Guideline-directed medical therapy (GDMT) improves heart failure outcomes, yet GDMT prescribing is low. Order sets can alter prescribing behavior. This study seeks to identify characteristics associated with order set use.

Methods: We conducted a retrospective cohort study on 841 adult patients admitted to TJUH with a primary diagnosis of heart failure. Variables included type of service (cardiology, hospital medicine, emergency department and other), whether the service attending was incentivized, and patient status (inpatient, observation). Association with order set use using chi-square tests. Data were extracted using Qlik. Analyses were conducted using Microsoft Excel. P-values of less than 0.05 were considered statistically significant.

Results: Incentivized services had significantly higher order set utilization (95% CI: +4.8- 13.0%; p=0.0001). Inpatient admissions demonstrated greater use compared with observation encounters (95% CI: +0.7-10.8%; p=0.029). Cardiology exhibited higher utilization compared with the emergency department (95% CI: +10.0-19.6%; p=0.0002) and other services (95% CI: +2.2-12.8%; p=0.0083). There was no difference between cardiology and hospital medicine (p=0.402).

Discussion: The data suggests incentives and education work. Cardiology and hospital medicine attendings were incentivized to improve heart failure outcomes and educated regarding how the order set can improve outcomes. Efficacy is supported by increased usage for cardiology relative to emergency department or other services and no difference relative to hospital medicine. This also explains the increased utilization among inpatient versus observation patients as the former are cared for by incentivized/educated attendings. The results suggest that meaningful improvements will likely require incentive-driven, system-level approaches rather than relying solely on teaching-based strategies.

Additional Files
Whitcomb_Maela_poster.pdf (931 kB)

Language

English

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