A Quality Improvement Collaborative to Improve Pediatric Primary Care Genetic Services
Michael L Rinke1, Amy Driscoll2, Natalie Mikat-Stevens3
1Department of Pediatrics, Children's Hospital at Montefiore, Bronx, New York; mrinke@montefiore.org.
Pediatrics
|January 30, 2016
Summary
A national quality improvement collaborative (QIC) shows promise for improving and sustaining better diagnosis and management of genetic disorders in pediatric primary care. This approach enhanced adherence to key process measures over time.
Area of Science:
- Pediatric Primary Care
- Quality Improvement Science
- Genetics and Genomics
Background:
- Adherence to process measures for diagnosing and managing pediatric genetic disorders can be suboptimal.
- Quality improvement collaboratives (QICs) are a strategy to enhance healthcare delivery.
- The effectiveness of national pediatric primary care QICs in improving genetic disorder care needs investigation.
Purpose of the Study:
- To assess if a national pediatric primary care quality improvement collaborative (QIC) can improve adherence to process measures for children with genetic disorders.
- To determine if improvements in adherence can be sustained after the QIC concludes.
Main Methods:
- Thirteen pediatric practices participated in a 6-month national QIC.
- Practices focused on 11 aims for improving diagnosis and management of genetic disorders.
- Adherence to process measures was evaluated at baseline, monthly during the QIC, and 6 months post-QIC using record reviews and regression analysis.
Main Results:
- Statistically significant improvements in adherence were observed for 4 of 7 aims during the active improvement period.
- Examples include improved family history documentation (6% to 60%) and care for specific genetic disorders (58% to 85%).
- These improvements were sustained 6 months after the QIC concluded.
Conclusions:
- A national pediatric primary care quality improvement collaborative (QIC) shows potential for enhancing and sustaining adherence to process measures for genetic disorder care.
- Further research should explore patient outcomes and optimal QIC aim selection.
- This model offers a promising framework for improving care for children with genetic conditions.
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