Clinical Decision Support Tool to Promote Adoption of New Neonatal Hyperbilirubinemia Guidelines

Abstract

OBJECTIVE: To increase adoption of revised newborn hyperbilirubinemia guidelines by building a clinical decision support (CDS) tool into templated notes. METHODS: We created a rule-based CDS tool that correctly populates the phototherapy threshold from more than 2700 possible values directly into the note and guides clinicians to an appropriate follow-up plan consistent with the new recommendations. We manually reviewed notes before and after CDS tool implementation to evaluate new guideline adherence, and surveys were used to assess clinicians’ perceptions. RESULTS: Post-intervention documentation showed a decrease in old risk stratification methods (48% to 0.4%, p<0.01) and increases in new phototherapy threshold usage (39% to 95%, p<0.01) and inclusion of follow-up guidance (28% to 79%, p<0.01). Survey responses on workflow efficiency and satisfaction did not significantly change after CDS tool implementation. CONCLUSION: Our study details an innovative CDS tool that contributed to increased adoption of newly revised guidelines after addition of this tool to templated notes. KEYWORDS: Hyperbilirubinemia, Clinical Decision Support Systems, Pediatrics