Family Linkages Supporting Hyperbilirubinema Guidelines. Abstract, ExecutiveSummary, Final Report

摘要

This project developed and implemented a computer-based decision support systemto enhance management of jaundiced infants, and evaluated its impact on clinicians' knowledge of and adherence to practice guidelines. The hyperBILIrubinemia Longitudinal Informatics Guidelines in HyperText (BiliLIGHT) system was based on a Children's Hospital, Boston, adaptation of the American Academy of Pediatrics guideline. The system linked disparate sources of medical information across multiple sites using the Internet. The evaluation used a quasi-experimental design, with before and after measurements in three sites receiving the intervention and three matched sites not receiving it. Performance on several review criteria, including obtaining a maternal history and assessing for a family history of hemolytic disease, improved at intervention sites. No meaningful differences in emergency department laboratory testing occurred. More infants in primary care intervention sites received at least one bilirubin test during the post-period. Reported knowledge about the evaluation and treatment of newborn jaundice increased significantly among both intervention and control site