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

Abstract

To increase adoption of revised newborn hyperbilirubinemia guidelines by building a clinical decision support (CDS) tool into templated notes. We created a rule-based CDS tool that correctly populates the phototherapy threshold from more than 2700 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 guideline adherence, and surveys were used to assess clinicians' perceptions. Post-intervention documentation showed a decrease in old risk stratification methods (48% to 0.4%, p<0.01) and increases 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. Our study details an innovative CDS tool that contributed to increased adoption of newly revised guidelines after addition of this tool to templated notes.