0916 Q4 no More: Optimizing Clincial Decision Support to Decrease Inpatient Sleep Disruptions

Abstract Introduction Orders such as vital signs (VS) and neurological checks (NC) contain frequency options to help clinicians align workflows with patient needs. However, these clinical decision support (CDS) systems often default around-the-clock, may over-accept leading unnecessary sleep disruptions. Methods We added two radio buttons VS/NC orders: q4 hour while awake (q4WA) TID (TIDWA). gave presentations on CDS inpatient neurology unit (INU) residents staff pre-intervention. sent reminders INU review modify (when appropriate) around-the-clock orders via secure chat. defined the pre-intervention period six months before post-intervention following. Order frequencies NC/VS performed from 11 pm–7 am were obtained EHR. Pre- data analyzed using interrupted time-series analysis (ITSA). Results Post-intervention, there was a significant decrease in order (VS 15% NC 17%,p< 0.001) across institution. Subgroup of revealed more reductions 54% 48%, p< 0.001). Sleep-friendly significantly increased for VS (0% 6.7%, 0% 7.8%). Sub-group again profound, sleep-friendly increasing 16% both NC. Additionally, overnight decreased by 11% 17% (p< at institution, further reduction (45% 35% NC, The case-mix index appropriately lower population (1.2749) versus (2.2684) Conclusion modifications reducing completed overnight. These results profound INU, indicating that combination changes, education, chat demonstrated higher impact than changes alone. Support (if any)