Developing and disseminating an electronic penicillin allergy de-labelling tool using the model for improvement...

Area of Science:

• Clinical Informatics
• Allergy and Immunology
• Quality Improvement Science

Background:

• Many clinicians hesitate to de-label penicillin allergies despite safety data.
• Electronic point-of-care tools can support providers in allergy de-labelling.
• This study aimed to increase provider intent for penicillin oral challenges by 15%.

Purpose of the Study:

• To assess the impact of an electronic point-of-care tool on clinician intent to perform penicillin allergy de-labelling.
• To evaluate provider satisfaction and confidence with the tool's risk-stratification capabilities.
• To improve the adoption and effectiveness of penicillin allergy de-labelling protocols.

Main Methods:

• A validated de-labelling algorithm was integrated into an electronic point-of-care tool.
• The tool was implemented across eight healthcare institutions using the Model for Improvement Framework and three PDSA cycles.
• Data on provider intent, tool usage, satisfaction, and confidence were collected and analyzed.

Main Results:

• Provider intent for penicillin oral challenges increased from 50.4% to 65.5% after tool implementation (15.1% increase).
• Monthly tool usage increased from 61.3 to 98.6 uses.
• Provider satisfaction rose to 100%, and confidence in risk stratification reached 98.1% with the improved tool version.

Conclusions:

• The quality improvement initiative successfully increased provider intent for penicillin allergy de-labelling.
• The electronic tool significantly enhanced provider satisfaction and confidence in risk stratification.
• Integrating electronic tools into institutional protocols is recommended for effective penicillin allergy de-labelling.