An Evidence-Based Approach to Development of Clinical Decision Support Tool to Diagnose Pediatric ADHD in the Rural Setting
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Background and Purpose: Primary care providers in this rural setting were not adhering to the American Academy of Pediatrics’ ADHD clinical practice guideline. The aim of this quality improvement project was to augment pediatric ADHD assessment practices in the rural setting through implementation of a clinical decision support tool. The project was completed in four rural ambulatory care facilities in Southwest Iowa. Project participants included: doctors of medicine, doctors of osteopathy, nurse practitioners, and physician assistants. Methods: A pediatric ADHD clinical decision support tool, which included DSM-5 diagnostic criteria, was designed for integration into the EMR. The clinicians were surveyed to assess interest in utilization and then educated about how to access the tool within the EMR. Conclusions: Leadership, collaboration, dedication, and advocacy are required when implementing change within large health care organizations. Expansions to this project should be based on longitudinal results and updated literature. Implications for practice: While this project was specific to assessing pediatric ADHD, the same process can be conducted to improve the assessment and management of other chronic disorders. Integration of a clinical decision support tool may contribute to the sustainability of improved ADHD assessments and has the potential to be utilized to measure future benchmarks for the ADHD standard of care.