Oral Concurrent Session 9 – Quality

Objective: Timely treatment of severe hypertension (HTN) and intraamniotic infection (IAI) are key quality metrics for labor and delivery (L&D) units.We evaluated whether riskLD, a clinical decision support tool integrated within electronic health records (EHR) which issues real-time alerts to prompt timely care, reduced treatment delays. Study Design:We conducted an interrupted time series study over 24 months (3/2023-2/2025) on a single tertiary care L&D unit.riskLD was implemented in February 2024.We assessed monthly rates of delayed initiation of antibiotics for IAI (>1 hour) after meeting ACOG-defined IAI criteria and delayed treatment of severe HTN (>1 hour) after two consecutive severe blood pressures.Segmented regression was used to assess trends over time.Prais-Winsten estimation was used to account for autocorrelation.Models included terms for pre-implementation trend, immediate change after riskLD implementation, and post-implementation trend.Results: There were 2992 and 3853 deliveries in the pre and post implementation periods, respectively.For IAI, there was a significant increasing trend in delayed treatment prior to riskLD implementation (β = +3.7% per month, p = 0.01), followed by a significant immediate 32% reduction in delayed treatment after riskLD implementation (p = 0.01) that remained stable post-implementation (p = 0.24).For severe HTN, there was no significant trend pre-implementation, however riskLD implementation was associated with a significant immediate 9% reduction in treatment delays (p = 0.048), which remained stable post-implementation (p = 0.40).Conclusion: Implementation of real-time EHR alerts via riskLD was associated with immediate and durable reductions in delayed treatment of IAI and severe HTN.