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Using quality improvement to promote implementation and increase well child visits in home visiting
Neera K Goyal1, Robert T Ammerman2, Julie A Massie3
1Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
Child Abuse & Neglect
|December 25, 2015
Summary
Home visiting programs improved well-child care (WCC) adherence for infants. Quality improvement strategies increased WCC visits, connecting more children to medical homes and enhancing early healthcare access.
Area of Science:
- Public Health
- Pediatrics
- Healthcare Quality Improvement
Background:
- Home visiting programs aim to link children with medical homes via well-child care (WCC) guidance.
- Low socioeconomic status families face significant barriers to WCC, hindering this goal.
- Quality improvement (QI) strategies, successful in healthcare, are emerging in home visiting.
Purpose of the Study:
- To increase the proportion of infants in a large, multi-site home visiting program receiving at least 3 recommended WCC visits within their first 6 months.
- To evaluate the effectiveness of implementing QI strategies within a home visiting context.
Main Methods:
- Conducted 33 QI cycles across 3 sites with 18 home visitors and 139 families.
- Monitored changes using trend charts, focusing on staff training, data collection, family tracking, and primary care communication.
- Implemented successful strategies program-wide after iterative data review.
Main Results:
- Baseline WCC adherence varied significantly (35%-83%) across sites.
- The percentage of infants completing at least 3 WCC visits increased from 58% to 86% during the project.
- QI initiatives demonstrated success in improving WCC adherence.
Conclusions:
- Quality improvement is an effective method for enhancing well-child care adherence in home visiting programs.
- This approach demonstrates a successful model for maximizing the impact of home visiting interventions.
- QI can overcome barriers to WCC, improving early healthcare access for vulnerable populations.
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