From bottlenecks to better practices: systemwide electronic clinical decision support for blood culture stewardship

Abstract A systemwide electronic clinical decision support (CDS) tool for blood culture ordering reduced utilization by 12% across three hospitals (IRR 0.88, P < .01), but the effect waned over time. Low-yield ordering persisted, and contamination rates increased. Sustained diagnostic stewardship likely requires multimodal strategies beyond CDS alone.