Clinical Decision Support Tool to Promote Adoption of New Neonatal Hyperbilirubinemia Guidelines.

Abstract

Objective:  This study aimed to increase the adoption of revised newborn hyperbilirubinemia guidelines by building a clinical decision support (CDS) tool into templated notes.

Methods:  We created a rule-based CDS tool that correctly populates the phototherapy threshold from more than 2,700 possible values directly into the note and guides clinicians to an appropriate follow-up plan consistent with the new recommendations. We manually reviewed notes before and after CDS tool implementation to evaluate new guidelines adherence, and surveys were used to assess clinicians' perceptions.

Results:  Postintervention documentation showed a decrease in old risk stratification methods (48 to 0.4%, p < 0.01) and an increase in new phototherapy threshold usage (39 to 95%, p < 0.01) and inclusion of follow-up guidance (28 to 79%, p < 0.01). Survey responses on workflow efficiency and satisfaction did not significantly change after CDS tool implementation.

Conclusion:  Our study details an innovative CDS tool that contributed to increased adoption of newly revised guidelines after the addition of this tool to templated notes.