Implementation of a Clinical Decision Support (CDS) Tool for the Management of Functional Constipation in Pediatric...

Area of Science:

• Pediatric Gastroenterology
• Clinical Informatics
• Quality Improvement Science

Background:

• Pediatric constipation is a frequent issue in general pediatrics, often leading to referrals to subspecialists.
• Current management pathways may result in unnecessary subspecialty care, impacting healthcare resources and patient access.
• Challenges in primary care management necessitate innovative solutions to optimize pediatric constipation care.

Purpose of the Study:

• To develop and implement a clinical decision support tool for managing pediatric constipation in primary care.
• To evaluate the impact of this tool on provider workflow, confidence, and subspecialty referral rates.
• To assess the feasibility of integrating decision support into electronic health records for pediatric constipation management.

Main Methods:

• A multidisciplinary team conducted a root cause analysis of challenges in pediatric constipation care.
• A Clinical Decision Support tool and patient educational materials were developed.
• These interventions were embedded within an electronic health record order-set and implemented in a primary care network.

Main Results:

• The use of the updated electronic health record order-set has shown a consistent monthly increase.
• Primary care providers reported improvements in workflow and increased confidence in managing pediatric constipation.
• The interventions demonstrated feasibility for supporting primary care clinicians.

Conclusions:

• Implementing a Clinical Decision Support tool is a feasible strategy to enhance primary care management of pediatric constipation.
• Such tools can potentially reduce unnecessary referrals to pediatric gastroenterology.
• This quality improvement initiative highlights the value of integrated electronic health record tools in pediatric primary care.