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ForwardWMJ Vol 124 Issue 2: Impact of an Integrated Electronic Health Record Protocol on Inferior Vena Cava Filter Retrieval Attempt Rates: An Observational Cohort Study
ABSTRACT
Introduction: To improve inferior vena cava (IVC) filter retrieval rates, an electronic health record prompt for scheduling retrieval before patient discharge was implemented.
Methods: This retrospective comparative cohort study was conducted in a single Midwestern tertiary care medical center. Adult patients with IVC filters placed for a medical (Medical subgroup) or trauma (Trauma subgroup) indication before and after protocol implementation and who had follow-up documented in the electronic health record were included. IVC filter retrieval attempt rates both overall and by indication for placement before and after protocol implementation were compared.
Results: Three hundred eighty-five patients met eligibility criteria: 223 before implementation (Before group) and 162 after implementation (After group). The attempted retrieval rate for the After group was 11.4% higher than the Before group (P = .012). Attempted retrieval rates in the Medical Before and After subgroups were 56.2% and 76.0%, respectively (P = .001). The Trauma subgroups’ rates were similar to each other (P = .594). Time to retrieval attempt was significantly shorter in the Medical After subgroup than in the Medical Before subgroup (P = .018) but similar in the Trauma subgroups.
Conclusions: Attempted retrieval rates were significantly higher in the After group and Medical After subgroup. Trauma subgroup rates were similar, likely because a previous intervention to increase retrieval in trauma patients was in place during the pre-implementation period of our study. Findings suggest that using an automated electronic health record-based prompt to facilitate IVC filter retrieval scheduling could greatly improve retrieval rates and patient safety.
Intended Audience
The intended audience for this continuing education activity is healthcare professionals caring for the people of Wisconsin and beyond.
Learning Objectives
As a result of participating in this journal-based activity, healthcare team members will be able to:
- Explain the clinical indications for inferior vena cava (IVC) filter placement, the risks associated with long-term retention, and the importance of timely retrieval to improve patient safety.
- Summarize findings from a retrospective cohort study of 385 patients comparing IVC filter retrieval attempt rates before and after implementation of an electronic health record (EHR)
prompt for scheduling retrieval before patient discharge. - Discuss using an automated electronic health record-based prompt and multidisciplinary approaches to facilitate IVC filter use and retrieval, enhance patient safety, and reduce complications.
FACULTY DISCLOSURE
It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the speakers/presenters, authors, planners, and other persons who may influence the content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.
For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.
| Name of Individual | Individual's Role in Activity | Financial Relationship Disclosure | Discussion of Unlabeled/Unapproved Uses of Drugs/Devices |
| Marianna Shershneva, MD, PhD | Accreditation Specialist | No relevant relationships with ineligible companies to disclose | No |
| James Eberhard, MFA | Accreditation Specialist | No relevant relationships with ineligible companies to disclose | No |
| Benjamin M. Parsons, DO | Author | No relevant relationships with ineligible companies to disclose | No |
| Sean R. O’Neil, MD | Author | No relevant relationships with ineligible companies to disclose | No |
| Andrew L. Horstman, PA-C | Author | No relevant relationships with ineligible companies to disclose | No |
| Mary C. Oldenburg, MS | Author | No relevant relationships with ineligible companies to disclose | No |
| Attila J. Kovacs, PhD | Author | No relevant relationships with ineligible companies to disclose | No |
| C. Isaiah Fitzmaurice, MS | Author | No relevant relationships with ineligible companies to disclose | No |
| Samuel Mosiman, MS | Author | No relevant relationships with ineligible companies to disclose | No |
| Tiana L. Carlson, BS | Author | No relevant relationships with ineligible companies to disclose | No |
| Venkata Manchala, MD | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Maria C Mora Pinzon, MD, MS | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Fahad Aziz, MD | Editor | No relevant relationships with ineligible companies to disclose | No |
| David Dwyer, PhD, RN, NEBC | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Laura Ozkan, PA | Reviewer | No relevant relationships with ineligible companies to disclose | No |
| Jessica Leiberg, DNP, ACNP | Reviewer | No relevant relationships with ineligible companies to disclose | No |
*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients. The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.
Accreditation and Credit Designation Statements
Accreditation Logos | Accreditation Statements |
 | In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. |
American Medical Association (AMA) The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. | |
American Nurses Credentialing Center (ANCC) The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 0.75 ANCC contact hour. | |
 | American Academy of Physician Assistants (AAPA) The University of Wisconsin–Madison ICEP has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.75 AAPA Category 1 CME credits. Approval is valid until 03/25/2027. PAs should only claim credit commensurate with the extent of their participation. |
Continuing Education Units The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.075 continuing education units (CEUs) or 0.75 hours. |
Available Credit
- 0.75 AAPA Category 1 CME
- 0.75 AMA PRA Category 1 Credit™
- 0.75 ANCC Contact Hours
- 0.75 University of Wisconsin–Madison Continuing Education Hours
- 0.75 Approved for AMA PRA Category 1 Credit™
Accessibility
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