Improved utilization of a standardized order set for patients care for in a tertiary care inflammatory bowel disease clinic with the introduction of an Express lane

3:30 PM–4:30 PM May 19, 2020 (Conference Time: US - Pacific)

3:30 PM–4:30 PM May 19, 2020

Regency Prefunction


Abstract: Description of Problem or Gap:
Care of patients (pts) with inflammatory bowel disease (IBD) can be complex. Studies have shown standardization of care within a practice can improve outcomes, but this can be difficult to achieve. In order to improve this, many providers in our organization have made personalized preference order sets.
In order to standardize care of patients with IBD at VUMC, an “IBD Smartset” was developed. This included correct laboratory, radiology, and referral orders, and medications tailored to care of pts with IBD. Providers were educated about the SmartSet in person and via an emailed educational handout. Despite this education, use of the Smartset was low.
Approximately 2 months later, an “IBD Express Lane” was introduced which opens with every encounter in the IBD clinic. It includes access to IBD-related visit diagnosis, notes, billing, orders, and send notes to other providers in one window. The “IBD Smartset” was embedded into this Express lane. Education regarding the Express lane was done in the same manner.
In the 21 days prior to go-live of the IBD Express Lane, an average of 6.7 (SD = 9.5) orders were placed from the IBD SmartSet per day. After the IBD Express Lane went live, this increased to 33.0 (SD = 37.4) orders per day (P < 0.001 using Poisson regression).
Discussion of Results:
Significantly increased utilization of standardized orders occurred when using Express lane compared to Smartset by allowing easier practitioner interface to Smartsets. This will allow for improved standardized order use and reduce errors. This process can be expanded to other clinic areas.
Allowing streamlined and improved access to a smartset by embedding this into an express lane that automatically opens when a clinic encounter opens significantly improves utilization of a smartset.
Take-Away Tool:
Express Lanes that open when a clinic encounter is opened significantly improve order set utilization.

Describe the new knowledge and additional skills the participant will gain after attending your presentation.: Smartsets can improve standardized order utilization but uptake of these can be difficult. Express Lanes that open automatically when a clinic encounter opens can significantly improve standardized order utilization.


Sara Horst, Vanderbilt University Medical Center
Kristy Bishop, Vanderbilt University Medical Center
Adam Wright (Presenter)
Vanderbilt University Medical Center