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

Sujen Saravanabavan¹, Patrick McKernan², Scott Cameron^3,4

¹BC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada. sujen.saravanabavan@gmail.com.

Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology

|December 24, 2024

Summary

A new electronic tool improved clinician intent to perform penicillin allergy de-labelling oral challenges by over 15%. The tool also enhanced provider satisfaction and confidence in risk stratification for penicillin allergies.

Keywords:

Antibiotic allergy Clinical Decision support systems Drug hypersensitivity Patient safety Penicillin allergy Penicillin hypersensitivity Quality improvement

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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.