{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T02:23:17Z","timestamp":1767666197779,"version":"build-2065373602"},"reference-count":14,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,7,28]],"date-time":"2015-07-28T00:00:00Z","timestamp":1438041600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Cellulitis is a common infection with wide variation of clinical care.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To implement an evidence\u2010based care pathway and evaluate changes in process metrics, clinical outcomes, and cost for cellulitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN<\/jats:title><jats:p>A retrospective observational pre\u2010\/postintervention study was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>SETTING<\/jats:title><jats:p>University of Utah Health Care, a 500\u2010bed academic medical center in Salt Lake City, Utah.<\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS<\/jats:title><jats:p>All patients 18 years or older admitted to the emergency department observation unit or hospital with a primary diagnosis of cellulitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>INTERVENTION<\/jats:title><jats:p>Development of an evidence\u2010based care pathway for cellulitis embedded into the electronic medical record with education for all emergency and internal medicine physicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>MEASUREMENTS<\/jats:title><jats:p>Primary outcome of broad\u2010spectrum antibiotic use. Secondary outcomes of computed tomography\/magnetic resonance imaging orders, length of stay (LOS), 30\u2010day readmission, and pharmacy, lab, imaging, and total facility costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 677 visits occurred, including 370 visits where order sets were used. Among all patients, there was a 59% decrease in the odds of ordering broad\u2010spectrum antibiotics (<jats:italic>P<\/jats:italic> &lt; 0.001), 23% decrease in pharmacy cost (<jats:italic>P<\/jats:italic> = 0.002), and 13% decrease in total facility cost (<jats:italic>P<\/jats:italic> = 0.006). Compared to patients for whom order sets were not used, patients for whom order sets were used had a 75%, 13%, and 25% greater decrease in the odds of ordering broad\u2010spectrum antibiotics (<jats:italic>P<\/jats:italic> &lt; 0.001), clinical LOS (<jats:italic>P<\/jats:italic> = 0.041), and pharmacy costs (<jats:italic>P<\/jats:italic> = 0.074), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>The evidence\u2010based care pathway for cellulitis improved care at an academic medical center by reducing broad\u2010spectrum antibiotic use, pharmacy costs, and total facility costs without an adverse change in LOS or 30\u2010day readmissions. <jats:italic>Journal of Hospital Medicine<\/jats:italic> 2015;10:780\u2013786. \u00a9 2015 Society of Hospital Medicine<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.2433","type":"journal-article","created":{"date-parts":[[2015,7,28]],"date-time":"2015-07-28T10:47:26Z","timestamp":1438080446000},"page":"780-786","source":"Crossref","is-referenced-by-count":27,"title":["Evidence\u2010based care pathway for cellulitis improves process, clinical, and cost outcomes"],"prefix":"10.1002","volume":"10","author":[{"given":"Peter M.","family":"Yarbrough","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Division of General Medicine University of Utah Medical Center Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Polina V.","family":"Kukhareva","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics University of Utah Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily Sydnor","family":"Spivak","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Infectious Diseases University of Utah Medical Center Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christy","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine University of Utah Medical Center Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kensaku","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics University of Utah Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp031807"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/313525"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055356"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-1609.2009.00127.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.29"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/497143"},{"key":"e_1_2_7_8_1","first-page":"1","article-title":"Clinical practice guidelines by the Infectious Disease Society of American for the treatment of methicillin\u2010resistant Staphylococcus aureus infectious in adults and children","volume":"42","author":"Liu C","year":"2011","journal-title":"Clin Infect 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