Action plans into action - An electronic action plan generation tool at a paediatric centre

Area of Science:

• Pediatric Allergy and Immunology
• Health Informatics
• Clinical Quality Improvement

Background:

• Individualised Action Plans (APs) are crucial for managing paediatric conditions like asthma, allergy, anaphylaxis, and eczema.
• While APs are a quality marker, their content has been under-examined.
• The Royal Children's Hospital (RCH) implemented an Electronic Medical Record (EMR)-integrated AP generation tool in 2017.

Purpose of the Study:

• To evaluate the benefits of a hospital-wide integrated AP tool.
• To assess the uptake and usage of the AP tool at RCH.
• To identify quality and user interface issues through AP content audits.

Main Methods:

• A retrospective observational analysis of all APs generated in the RCH EMR for patients aged 0-18 years during 2018.
• Extraction and analysis of automatically populated and clinician-entered data fields from each AP.

Main Results:

• A total of 2637 APs were completed, with asthma plans being the most frequent.
• Omission rates of critical information were low but indicated room for improvement.
• Variations in AP completion location (Emergency Department vs. clinic) and clinician role (consultant vs. junior staff) were observed.

Conclusions:

• The EMR-integrated AP tool demonstrated considerable institutional uptake.
• Electronic APs facilitate qualitative usage evaluation and content auditing.
• Findings will inform further system and user interface enhancements to improve AP quality.