{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:07:35Z","timestamp":1791220055095,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,11,24]],"date-time":"2024-11-24T00:00:00Z","timestamp":1732406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment of alcohol withdrawal syndrome (AWS) in hospitals is inconsistent. Electronic health record (EHR) order sets protocolize care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We examined variation in AWS order sets across hospital organizations and their concordance with AWS guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cross\u2010sectional study of hospital organization user\u2010created EHR order sets for AWS extracted from the December 2021 Epic\u00ae userweb community library. Hospital organizations with an acute care hospital and 1 AWS order set were included. We measured the proportion of guideline\u2010concordant care practices within four categories: (1) laboratory assessment, (2) risk assessment for severe AWS and associated management changes, (3) symptom assessment and treatment of AWS, and identification and management of complications and (4) screening, diagnosis, and treatment of unhealthy alcohol use and AUD including medications for alcohol use disorder (MAUD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010five organizations with 289 order sets were included. The proportion of organizations with guideline\u2010concordant laboratory assessments included testing of electrolytes (83%), hepatic function (75%), substance use (83%), and screening for infections (33%). Guidance for assessing risk of severe AWS (34%) and indications for care escalation (63%) used inconsistent definitions. Use of guideline\u2010concordant medications for AWS (99%) and AWS symptom scores (91%) were nearly universal. MAUD was included by two organizations (2%). A common templated order set was used by 26% of organizations in EHR order sets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed frequent organizational inclusion of guideline\u2010concordant medications and symptom scores but rare and\/or poorly defined guidance for evaluating risk of severe AWS, escalation of care, and MAUD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.13556","type":"journal-article","created":{"date-parts":[[2024,11,24]],"date-time":"2024-11-24T07:29:32Z","timestamp":1732433372000},"page":"550-561","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Guideline concordance of electronic health record order sets for hospital\u2010based treatment of alcohol withdrawal syndrome"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7054-3217","authenticated-orcid":false,"given":"Shawn M.","family":"Cohen","sequence":"first","affiliation":[{"name":"Program in Addiction Medicine, Section of General Internal Medicine, Yale School of Medicine New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitu","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Emory University Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa L.","family":"Steel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine Harborview Medical Center, University of Washington School of Medicine Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Jennifer","family":"Edelman","sequence":"additional","affiliation":[{"name":"Program in Addiction Medicine, Section of General Internal Medicine, Yale School of Medicine New Haven Connecticut USA"},{"name":"Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA"},{"name":"Department of Social and Behavioral Science Yale School of Public Health New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Fiellin","sequence":"additional","affiliation":[{"name":"Program in Addiction Medicine, Section of General Internal Medicine, Yale School of Medicine New Haven Connecticut USA"},{"name":"Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA"},{"name":"Department of Emergency Medicine Yale School of Medicine New Haven Connecticut USA"},{"name":"Department of Health Policy and Management Yale School of Public Health New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Joudrey","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"},{"name":"Department of Medicine, Center for Research on Health Care University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,24]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Healthcare Cost and Utilization Project (HCUP) Statistical Briefs","author":"Owens PL","year":"2019"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-07069-w"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000576"},{"issue":"3","key":"e_1_2_8_5_1","first-page":"1","article-title":"The ASAM clinical practice guideline on alcohol withdrawal management","volume":"14","author":"Wong J","year":"2020","journal-title":"J Addict Med"},{"issue":"2","key":"e_1_2_8_6_1","first-page":"35","article-title":"Missed opportunities for health promotion intervention in the management of alcohol withdrawal syndrome","volume":"168","author":"Johnson J","year":"2016","journal-title":"J Louisiana State Med Soc"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2021.11.010"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066619847119"},{"issue":"2","key":"e_1_2_8_9_1","first-page":"293","article-title":"Initiation of medication for alcohol use disorder for inpatients with alcohol withdrawal syndromes","volume":"84","author":"Krimpuri R","year":"2023","journal-title":"J Stud Alcohol Drugs"},{"key":"e_1_2_8_10_1","volume-title":"Advances in Patient Safety: New Directions and Alternative Approaches (Vol 2: Culture and Redesign)","author":"Ballard DJ","year":"2008"},{"key":"e_1_2_8_11_1","volume-title":"CADTH Rapid Response Reports. 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