This study will evaluate the impact of implementing an educational clinical decision support (CDS) tool designed to guide perioperative cardiovascular evaluation for adults undergoing urgent inpatient surgery. The CDS tool, integrated within the Epic electronic health record via AgileMD, provides evidence-informed recommendations regarding perioperative cardiac testing and specialty consultation based on American Heart Association guidance and multidisciplinary institutional consensus. The investigators will conduct a retrospective and prospective pre-post observational cohort study comparing perioperative cardiovascular testing intensity, consultation patterns, time to operating room, and clinical outcomes before and after implementation of the tool among adult patients admitted through the emergency department at Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center who undergo urgent surgery. Data will be obtained from the Core for Clinical Research Data Acquisition (CCDA) and Epic electronic health record, with case-level chart review performed as needed to validate rare outcomes such as major adverse cardiac events.
Adults age 18 years or older
Admitted through the Emergency Department at Johns Hopkins Hospital or Johns Hopkins Bayview Medical Center Undergoing urgent inpatient surgery during the index hospitalization
Elective surgeries,
Outpatient procedures,
Procedures followed only by observation or extended-stay recovery rather than inpatient admission,
Patients younger than 18 years old
Adults admitted through the Emergency Department to Johns Hopkins Hospital (JHH) Downtown or JHH Bayview Medical center above the age of 18 who require surgery during the stay.
Cohort
Prospective
Not listed
Rate of preoperative tests and consult orders
Cardiovascular Testing and Consultative Intensity. Rate of preoperative tests and consult orders per patient per admission.
Major Adverse Cardiac Events (MACE)
Major Adverse Cardiac Events (MI, Cerebrovascular Accident, Unstable Arrhythmia, Myocardial Injury after Non-cardiac Surgery (MINS), Sudden Cardiac Death)
Time to OR
Time from Presentation at the ED to start of Surgery
Click on the lead sponsor to view all of their trials.
Johns Hopkins University
Lead sponsor
Agency For Healthcare Research & Quality
Collaborator
Patient-Centered Outcomes Research Institute
Collaborator
This trial is not recruiting at the moment. You can still explore other options:
