| Abstract: |
Inadvertent automatic implantable cardioverter defibrillator (AICD) shocks at the end of life are distressing and should be avoided.1 2 Up to 65% of AICDs are active and up to 33% of patients with AICDs receive shocks within 24 hours of dying.3 Though guidelines encourage device discussions, one study demonstrated only 27% of clinicians brought up AICD deactivation.2 4 Since the Health Information Technology for Economic and Clinical Health Act was passed in 2009, clinicians and IT professionals introduced evidence-based clinical decision support (CDS) models into patient care, including order sets and alerts.5 Our group was the first to demonstrate that educational sessions paired with a novel CDS tool in the electronic medical record (EMR) significantly improved the rates of AICD deactivation discussions and of shock function deactivation.6 However, a criticism was that the labour-intensive teaching sessions drove most of the improvement and EMR modifications are ineffective. As a result, we sought to investigate whether the CDS tool alone invoked more AICD deactivation discussions and AICD deactivations. © |
