nstitutet, Stockholm, Sweden; 2Karolinska University PB1178|Pulmonary Embolism Diagnosis: Let’s Practice what weHospital, Stockholm, Sweden Background: Pulmonary embolism (PE) is a popular and potentially life-threatening condition. Because it can be deemed a “do not miss” diagnosis, PE tends to become over-investigated beyond the evidence-based clinical selection assistance systems (CDSS), which in turn exposes sufferers to unnecessary radiation and contrast agent exposure with no apparent advantages in terms of outcome. Aims: Employing computed tomography pulmonary angiogram (CTPA) because the gold typical for diagnosis of acute pulmonary embolism (PE), we evaluated the predictive overall performance of clinical hunch (gestalt) and 4 CDSS; PERC Rule, Wells score, revised ERK Activator Biological Activity Geneva score, and Years criteria. Approaches: A critique was performed around the Electronic Health-related Records (EMR) of 1655 patients in the Emergency Department inside a tertiary teaching hospital who underwent CTPA from 1 Jan 2018 to 31 Dec of 2019. According to the data from EMR, the scores for the four CDSS was calculated retrospectively. The patients were divided into five groups: “clinical hunch”, PERC rule, Wells score, revised Geneva score and YEARS criteria. We viewed as a CTPA ordered purely on a clinical hunch when there was no mention of CDSS in the EMR and no D-dimer. Background: We found that emergency physicians do not often use D-dimer for pulmonary embolism (PE) testing. We implemented PE testing pathway which necessary D-dimer testing for all patients suspected of obtaining PE. Aims: To evaluate the adherence to and clinical impact of your new PE testing pathway. Approaches: We enrolled consecutive adult individuals tested for PE in between January 2018 and January 2021 in two Canadian emergency departments. In November 2019, we implemented a brand new PE testing pathway. Outcomes just before and right after the intervention had been compared working with two-level generalized linear model, adjusting for patient age and gender, time in the day (day vs night-time), days of week (weekdays vs weekend), physician gender and years of encounter F. Germini; F. Al-haimus; Y. Hu; S. Niaz; N. Clayton; S. Mondoux; Q. Ibrahim; L. Thabane; K. de Wit McMaster University, Hamilton, Canada Preach. A High-quality Improvement Study to Boost Adherence to Evidence-based PE Diagnosis inside the Emergency DepartmentABSTRACT865 of|and study site. Adjusted odds ratio (aOR) are presented using the relative 95 confidence intervals. Outcomes: 5085/70,911 (7.2 ) eligible patients have been tested for PE prior to the intervention, 3854/36,530 (10.6 ) immediately after, with an aOR of 1.42 (1.35, 1.50). The aOR for following the protocol was three.10 (2.53, three.80), for use of DPP-2 Inhibitor Formulation imaging 1.01 (0.92, 1.11), imaging positive yield 0.97 (0.79, 1.19), use of imaging in sufferers with a unfavorable D-dimer 0.28 (0.23, 0.35), PE diagnosis amongst tested sufferers 0.98 (0.81, 1.19), central PE (segmental or extra proximal) among all PEs 1.44 (0.80, 2.58). The false unfavorable price for PE testing was 4/5085 (0.08 ) before and 1/3854 (0.03 ) right after intervention [percentage distinction of – 0.05 (- 0.15, 0.04)]. Conclusions: Implementation of a new PE testing pathway was associated with a rise in PE testing, enhanced adherence to Ddimer use and no adjust in imaging use or PE testing yield.Table 1 Doctor and registered nurse Wells score assignment and agreementWells score assignment physicians and registered nurses (n, ) Doctor scores Modified Wells score two Modified Wells score two Total (n) 63 (44.7) Regi