METHODS: In an effort to provide timely access to allergy evaluation within a tertiary care pediatric academic center, the Early Peanut Introduction Clinic (EPIC) was established in September, 2016. EPIC is staffed by 2 allergists per session and can accommodate 8 patients during a dedicated one half-day session each month. Skin prick testing and depending upon results, supervised peanut introduction are offered.
RESULTS: EPIC had only one new patient referral during the first 6 months. A quality improvement (QI) project was developed to increase the percentage of filled EPIC appointments per month from 0% to 50% within 6 months. Using QI methodology and multiple Plan-Do-Study-Act cycles, several interventions were developed, including: implementation of an electronic referral, education/outreach to primary care physicians and dermatologists, and development of educational materials for placement in referring physician offices.
One month after QI initiatives began, 25% of EPIC appointment slots were filled, followed by an increase to 50% by month 4, 75% by month 5, and 63% by month 6.
CONCLUSIONS: Use of QI methodology increased referrals to a clinic established to assist new guideline implementation for early introduction of peanut, which requires timely access to allergy evaluation.