How to Encourage Outpatient Management of Low-Risk Patients with Pulmonary Embolism

Low-risk pulmonary embolism (PE) patients need not be hospitalized (NEJM JW Emerg Med Feb 2016 and Chest 2016; 149:315). Outpatient management promotes more-efficient use of resources and reduces exposure to unnecessary risks and costs associated with hospitalization.

Researchers allocated 10 emergency departments (EDs) to receive an intervention and 11 to serve as controls. All 21 EDs were part of the Kaiser Permanente Northern California system. Intervention as opposed to control sites were selected based on availability of a physician champion, not by randomization. The intervention consisted of electronic clinical decision support, coupled with education, incentives, and provider-specific feedback. The investigators compared outcomes of …