Brian P Jenssen1, Eric D Shelov2, Christopher P Bonafide2, Steven L Bernstein3, Alexander G Fiks2, Tyra Bryant-Stephens2. 1. Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, PA. 2. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia , Philadelphia, PA. 3. Department of Emergency Medicine, Department of Health Policy, Yale School of Public Health, Yale Cancer Canter and Yale School of Medicine , New Haven, CT.
Abstract
OBJECTIVES: To create and evaluate the feasibility, acceptability, and usability of a clinical decision support (CDS) tool within the electronic health record (EHR) to help pediatricians provide smoking cessation counseling and treatment to parents of hospitalized children exposed to secondhand smoke (SHS). METHODS: Mixed method study of first-year pediatric residents on one inpatient unit. Residents received training in smoking cessation counseling, nicotine replacement therapy (NRT) prescribing, and use of a CDS tool to aid in this process. The tool, which alerted when a patient was identified as exposed to SHS based on the history taken on admission or during a prior encounter, had the following capabilities: adding SHS exposure to the patient's problem list; referral to Free Quitline through discharge instructions; and linking to a printable NRT prescription form. We measured feasibility by EHR utilization data. We measured acceptability and usability of the tool by administering questionnaires to residents. RESULTS: From June-August 2015, the alert triggered for 106 patients, and the tool was used for 52 (49%) patients. 41 (39%) patients had SHS exposure added to the problem list, 34 (32%) parents were referred to the Quitline through discharge instructions, and 15 (14%) parents were prescribed NRT. 10 out of 15 (67%) eligible pediatricians used the tool. All clinicians surveyed (9 out of 10) found the tool acceptable and rated its usability good to excellent (average System Usability Scale score was 85 out of 100, 95% CI, 76-93). CONCLUSIONS: A non-interruptive CDS tool to help residents provide smoking cessation counseling in the hospital was feasible, acceptable, and usable. Future work will investigate impacts on patient outcomes.
OBJECTIVES: To create and evaluate the feasibility, acceptability, and usability of a clinical decision support (CDS) tool within the electronic health record (EHR) to help pediatricians provide smoking cessation counseling and treatment to parents of hospitalized children exposed to secondhand smoke (SHS). METHODS: Mixed method study of first-year pediatric residents on one inpatient unit. Residents received training in smoking cessation counseling, nicotine replacement therapy (NRT) prescribing, and use of a CDS tool to aid in this process. The tool, which alerted when a patient was identified as exposed to SHS based on the history taken on admission or during a prior encounter, had the following capabilities: adding SHS exposure to the patient's problem list; referral to Free Quitline through discharge instructions; and linking to a printable NRT prescription form. We measured feasibility by EHR utilization data. We measured acceptability and usability of the tool by administering questionnaires to residents. RESULTS: From June-August 2015, the alert triggered for 106 patients, and the tool was used for 52 (49%) patients. 41 (39%) patients had SHS exposure added to the problem list, 34 (32%) parents were referred to the Quitline through discharge instructions, and 15 (14%) parents were prescribed NRT. 10 out of 15 (67%) eligible pediatricians used the tool. All clinicians surveyed (9 out of 10) found the tool acceptable and rated its usability good to excellent (average System Usability Scale score was 85 out of 100, 95% CI, 76-93). CONCLUSIONS: A non-interruptive CDS tool to help residents provide smoking cessation counseling in the hospital was feasible, acceptable, and usable. Future work will investigate impacts on patient outcomes.
Authors: Alexander G Fiks; Evaline A Alessandrini; Christopher B Forrest; Saira Khan; A Russell Localio; Andreas Gerber Journal: J Am Med Inform Assoc Date: 2010-12-06 Impact factor: 4.497
Authors: Amit X Garg; Neill K J Adhikari; Heather McDonald; M Patricia Rosas-Arellano; P J Devereaux; Joseph Beyene; Justina Sam; R Brian Haynes Journal: JAMA Date: 2005-03-09 Impact factor: 56.272
Authors: Jodie A Trafton; Susana B Martins; Martha C Michel; Dan Wang; Samson W Tu; David J Clark; Jan Elliott; Brigit Vucic; Steve Balt; Michael E Clark; Charles D Sintek; Jack Rosenberg; Denise Daniels; Mary K Goldstein Journal: Implement Sci Date: 2010-04-12 Impact factor: 7.327
Authors: Jakobi Johnson; Karen M Wilson; Chuan Zhou; David P Johnson; Chén C Kenyon; Joel S Tieder; Andrea Dean; Rita Mangione-Smith; Derek J Williams Journal: J Hosp Med Date: 2019-04 Impact factor: 2.960
Authors: Magaly Ramirez; Richard Maranon; Jeffery Fu; Janet S Chon; Kimberly Chen; Carol M Mangione; Gerardo Moreno; Douglas S Bell Journal: J Am Med Inform Assoc Date: 2018-09-01 Impact factor: 4.497
Authors: Brian P Jenssen; Naveen Muthu; Mary Kate Kelly; Hilary Baca; Justine Shults; Robert W Grundmeier; Alexander G Fiks Journal: Am J Prev Med Date: 2019-05-21 Impact factor: 5.043
Authors: Eve Angeline Hood-Medland; Susan L Stewart; Hien Nguyen; Mark Avdalovic; Scott MacDonald; Shu-Hong Zhu; Antonio Mayoral; Elisa K Tong Journal: Appl Clin Inform Date: 2019-10-02 Impact factor: 2.342
Authors: Brian P Jenssen; Dean J Karavite; Shannon Kelleher; Ekaterina Nekrasova; Jeritt G Thayer; Raj Ratwani; Judy Shea; Emara Nabi-Burza; Jeremy E Drehmer; Jonathan P Winickoff; Robert W Grundmeier; Robert A Schnoll; Alexander G Fiks Journal: Appl Clin Inform Date: 2022-05-18 Impact factor: 2.762
Authors: E Melinda Mahabee-Gittens; Judith W Dexheimer; Meredith Tabangin; Jane C Khoury; Ashley L Merianos; Lara Stone; Gabe T Meyers; Judith S Gordon Journal: Am J Prev Med Date: 2018-01 Impact factor: 5.043
Authors: Esther Melinda Mahabee-Gittens; Ashley L Merianos; Judith W Dexheimer; Gabe T Meyers; Lara Stone; Meredith Tabangin; Jane C Khoury; Judith S Gordon Journal: Pediatr Emerg Care Date: 2020-11 Impact factor: 1.602