Electronic Support for Pulmonary Embolism Emergency Disposition

Many low-risk emergency department patients with acute pulmonary embolism are routinely
hospitalized despite being eligible for outpatient care. One impediment to home discharge is
the difficulty of identifying which patients can safely forego hospitalization. This
pragmatic clinical trial intends to evaluate the effect on emergency department disposition
of a multicomponent intervention, including electronic clinical decision support system
access, physician education, and physician-specific audit and feedback. The hypothesis for
this study is that intervention sites, when compared with concurrent control sites, will see
an increase in home discharges without an increase in 5-day pulmonary embolism-related return
visits or 30-day all-cause mortality.

Inclusion Criteria:

- Acute objectively-confirmed pulmonary embolism, diagnosed in the emergency department

Exclusion Criteria:

- Comfort-care only

- Left the ED against medical advice

- Current PE radiologically diagnosed >12 hrs prior to arrival

- Recent DVT or PE diagnosed within 30 days

- Pregnant