Allergy, Asthma & Clinical Immunology (Dec 2024)

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

  • Sujen Saravanabavan,
  • Patrick McKernan,
  • Scott Cameron,
  • Natasha Kwan,
  • Kristopher T. Kang,
  • Ashley Roberts,
  • Roxane Carr,
  • Raymond Mak,
  • Chelsea Elwood,
  • Vanessa Paquette,
  • Rochelle Stimpson,
  • Bethina Abrahams,
  • Edmond S. Chan,
  • Kathryn Slayter,
  • Alicia Rahier,
  • Irina Sainchuk,
  • Sharla Olsen,
  • Melissa Kucey,
  • Jinan Shamseddine,
  • Zahir Osman Eltahir Babiker,
  • Tiffany Wong

DOI
https://doi.org/10.1186/s13223-024-00942-3
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 8

Abstract

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Abstract Background Many clinicians feel uncomfortable with de-labelling penicillin allergies despite ample safety data. Point of care tools effectively support providers with de-labelling. This study’s objective was to increase the number of providers intending to pursue a penicillin oral challenge by 15% by February 2023. Methods A validated de-labelling algorithm was translated into an electronic point of care tool and disseminated to eight healthcare institutions. Applying the Model for Improvement Framework, three PDSA cycles were conducted, where collected data and completed surveys were analysed to implement changes. Number of providers intending to pursue an oral challenge, tool usage as well as number of clinicians who felt satisfied with the tool and felt confident in its ability to risk-stratify patients was collected. Results 50.4% of providers intended to give an oral challenge of penicillin with version 1, which improved to 65.5% with version 2, representing a 15.1% increase. With version 1 of the tool, there was an average of 61.3 counts of tool usage per month. 73.1% of providers felt satisfied with the tool and 76.9% felt confident in its ability to risk-stratify patients. With version 2 of the tool, after implementing changes through three PDSA cycles, monthly usage counts increased to an average of 98.6. Furthermore, 100.0% of providers felt satisfied with the tool and 98.1% felt confident with the tool’s ability to risk-stratify patients. Conclusion Our quality improvement approach demonstrated improvement in the percentage of providers that intended to pursue an oral challenge and felt satisfied and confident in the risk-stratification capabilities of penicillin allergy de-labelling tool. Electronic tools should be further incorporated into institutional penicillin de-labelling protocols.

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