Implementing a clinical decision support tool to increase early peanut introduction guidance

Area of Science:

• Pediatric allergy prevention
• Clinical informatics
• Public health

Background:

• Pediatric providers often lack confidence discussing early peanut introduction due to rapidly changing guidelines.
• Effective communication strategies are crucial for implementing updated infant feeding recommendations.

Purpose of the Study:

• To evaluate if a clinical decision support (CDS) tool can enhance discussions about early peanut introduction between providers and families.
• To assess the impact of a CDS tool on provider awareness, comfort, and the rate of successful peanut introduction.

Main Methods:

• Development and usability testing of a CDS tool integrated into electronic health records.
• Pre- and post-intervention evaluation of provider-family conversations regarding peanut introduction using electronic health record data.
• Provider surveys assessed guideline awareness and tool usability.

Main Results:

• Provider awareness of early peanut introduction guidelines increased from 17.8% to 66.7%.
• The CDS tool dramatically improved peanut introduction conversations across multiple well-child visits (WCCs), with rates rising from 2.4%-3.0% to over 80%.
• At 12-month WCCs, 62.8% of families had introduced peanut without concerns, with family unawareness of benefits being a key barrier for others.

Conclusions:

• A point-of-care CDS tool effectively promotes early peanut introduction discussions between pediatric providers and patients.
• CDS tools are valuable for quality improvement initiatives aiming to implement current clinical guidelines.