Multifaceted program to improve discharge on antiplatelets and statin medications
Bibliographic record
Abstract
Background Guidelines suggest that all vascular surgery patients should be discharged on antiplatelet (AP) and statin medications unless contraindicated; however, compliance varies across hospitals. Our objective was to assess the impact of a multifaceted, targeted, quality improvement (QI) program on compliance for discharge with AP and statin prescriptions. Methods A multifaceted program was developed to improve medication compliance for APs and statins at discharge by addressing barriers at the patient, staffing, and organizational levels. Organizational changes included prioritizing medication reconciliation of patients undergoing procedures who are likely to be discharged the same day, training designated project champions on the importance of medication compliance, and new standard documentation on discharge summary. Patient interventions included informational posters on the importance of discharge medication with an embedded QR code linking to a video on the same topic. Staffing interventions included reminders affixed to identification badges as well as the provision of education sessions at the nursing and prescriber level. The local Vascular Quality Initiative database was queried and rates of discharge with AP and statin were compared between 2022 and 2023, before and after implementation of our QI program. Results A total of 385 patients were included, 330 from 2022 and 223 from 2023. Prescription compliance rates in 2022 demonstrated room for improvement, particularly for patients undergoing endovascular aneurysm repair. Rates of medication therapy on admission were similar across both time periods. After program implementation, AP and statin therapy discharge rates increased across all groups, most notably in endovascular aneurysm repair procedures (80% vs 95%; P = .016). AP discharge compliance increased by 3% ( P = .592), statin discharge compliance increased by 5% ( P = .008), and overall discharge compliance on combination therapy increased from 84% to 97% ( P = .025). Conclusions A multifaceted education program addressing patient, nursing, and prescriber awareness of the importance of APs and statins on discharge can improve medication prescription rates.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".