Otto Alana K, Dyer Ashley A, Warren Christopher M, Walkner Madeline, Smith Bridget M, Gupta Ruchi S
1 Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
2 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Clin Pediatr (Phila). 2017 Jun;56(6):571-578. doi: 10.1177/0009922816669097. Epub 2016 Oct 26.
Pediatricians are often first-line providers for children with food allergy. Food allergy management guidelines have been developed but are cumbersome and confusing, and significant variation exists in pediatricians' management practices. We therefore consolidated the guidelines into 5 key steps for pediatricians caring for patients with food allergy and used rapid-cycle improvement methods to create a clinical decision support system to facilitate the management of food allergy in the primary care setting. This report details the development of the Food Allergy Support Tool (FAST), its pilot testing in 4 primary care pediatric practices, and our ongoing efforts to improve its utility and ease of use. Key themes identified during these processes include the importance of both initial and ongoing provider education as well as the limitations of a tool that must be actively initiated by providers.
儿科医生通常是食物过敏儿童的一线医疗服务提供者。虽然已经制定了食物过敏管理指南,但这些指南繁琐且令人困惑,儿科医生的管理实践存在显著差异。因此,我们将这些指南整合为照顾食物过敏患者的儿科医生的5个关键步骤,并使用快速循环改进方法创建了一个临床决策支持系统,以促进初级保健环境中食物过敏的管理。本报告详细介绍了食物过敏支持工具(FAST)的开发过程、在4个初级保健儿科实践中的试点测试,以及我们为提高其效用和易用性而持续做出的努力。在这些过程中确定的关键主题包括初始和持续的医疗服务提供者教育的重要性,以及必须由医疗服务提供者主动启动的工具的局限性。