A Quality Improvement Initiative Addressing Provider Prescription of Weight Management Follow-up in Primary Care

Area of Science:

• Pediatrics
• Public Health
• Quality Improvement Science

Background:

• Pediatric obesity is a growing concern, yet adherence to follow-up care recommendations is low.
• The American Academy of Pediatrics recommends timely weight management follow-up for children with overweight or obesity.
• Current practices show low rates of prescribed follow-up appointments between well-child visits.

Purpose of the Study:

• To improve the rate of weight management follow-up prescriptions for pediatric patients with obesity.
• To implement and evaluate a quality improvement initiative in a primary care setting.
• To increase the percentage of eligible children scheduled for follow-up weight management appointments.

Main Methods:

• A quality improvement project was conducted in a pediatric primary care clinic from May 2018 to April 2019.
• Interventions included provider education, electronic health record modifications, discharge order changes, and provider feedback.
• The primary outcome measured was the percentage of patients (ages 2-18, BMI ≥ 85th percentile) with a scheduled follow-up weight management appointment.

Main Results:

• Prescription rates for weight management follow-up increased from 32% at baseline to 58% post-intervention.
• Attendance at scheduled follow-up visits rose significantly, from 13% to 40% of prescribed patients.
• The no-show rate for these appointments was 35%.

Conclusions:

• Quality improvement methodologies effectively increased the prescription of weight management follow-up for pediatric patients.
• The initiative resulted in a higher number of children attending recommended follow-up visits.
• Further efforts are needed to address process failures and enhance patient engagement with follow-up care.