Implementation of a Preventive Services Bundle in Academic Pediatric Primary Care Centers

Pediatrics
Zeina M SamaanMona E Mansour

Abstract

Previous studies have documented poor rates of delivery of preventive services, 1 of the core services provided in the primary care medical home setting. We aimed to increase the reliability of delivering a bundle of preventive services to patients 0 to 14 months of age from 58% of patient visits to 95% of visits. The bundle includes administration of routine vaccinations, offering influenza vaccination, completed lead screening, completed developmental screening tool, screening for maternal depression and food insecurity, and documentation of gestational age. The setting was 3 academic pediatric primary care clinics that serve 31 000 patients (>90% Medicaid). Quality improvement methodology was used and key driver diagram was determined. Patient "Ideal Visit Flow" and the Responsible, Accountable, Support, Consulted, and Informed Matrix were developed to drive accountability for components of the ideal flow. Plan, Do, Study, Act cycles were used to develop successful interventions. The percent of patients seen who received all bundle elements for which they were eligible was plotted weekly on a run chart, and statistical process control methods were used to determine a significant change in performance. The preintervention per...Continue Reading

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Citations

Jul 20, 2017·Clinical Pediatrics·Julia M KimBarry S Solomon
Feb 18, 2016·Journal of Primary Care & Community Health·Margaret N JonesAndrew F Beck
Sep 11, 2018·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Courtney R LylesUrmimala Sarkar
Feb 10, 2017·Journal of Public Health Management and Practice : JPHMP·Paul Campbell ErwinJohn W Moran
Oct 5, 2018·Israel Journal of Health Policy Research·Moira Inkelas, Frank Oberklaid
Sep 22, 2017·American Journal of Public Health·Jennifer A MakelarskiStacy Tessler Lindau
Mar 7, 2021·The Journal of Pediatrics·Benjamin CarnahanBenjamin N Fogel
Mar 10, 2020·Pediatric Emergency Care·Victoria M Wurster OvalleMelissa D Klein
Dec 20, 2019·Pediatrics·Courtney M BrownRobert S Kahn

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