Did you know up to 90% of adults and 94% of children with a reported penicillin allergy are not actually allergic to the antibiotic? This misdiagnosis can have major implications on care, as patients are likely to be given other antibiotics which are less effective and have more side effects.
Bryan Ng, a medical student at the University of British Columbia, joined a team at the Provincial Health Services Authority (PHSA) through our Summer Student Internships to help advance understanding of the impacts of incorrect allergy labelling on patients and families. This internship was a great fit for Bryan, who completed a degree in pharmacy prior to entering medicine and found it difficult to assess and debunk the myth surrounding penicillin allergies in practice due to limited tools.
Tiffany Wong, a pediatric allergist and BC Quality Awards runner-up, supervised Bryan in outlining the aims of the project and acted as a quality improvement mentor. Bryan also received training through our program’s four-week online education series, which covers the fundamentals for change, the process for improvement, measuring and using data for improvement and how to generate, implement and sustain change ideas.
The PHSA team created DropTheLabel.ca, a hub of resources and tools for health care providers and patients, families and caregivers with the aim of improving awareness of allergy misdiagnosis and increasing the number of penicillin allergies reassessed and de-labeled.
Bryan conducted focus groups with patients to understand existing perceptions about their penicillin allergies. Through these conversations, he heard a common theme: a patient’s definition of an allergy was not the same as a doctor’s. These knowledge gaps around drug allergies needed to be addressed, which led Bryan to the next phase of his work.
The team engaged with patients to ensure that the DropTheLabel.ca was user-friendly and appropriate for the people it’s designed for, as well as to measure the impact of the resources available. A large part of Bryan’s work centred around website improvements and creating four new infographics – three for patients and one for providers – designed to share information that can demystify incorrect allergy diagnosis and support de-labelling. The infographics (below) are now in the process of being revised.
Bryan’s experience of applying ongoing quality improvement training to a real-world project was invaluable. Through regular connections with the program’s 10 other interns across BC and the Yukon, he was also able to engage in peer-to-peer learning and discussions of project challenges and successes to strengthen his experience.