Improving Lead Screening Rates in a Large Pediatric Primary Care Network
Joel R Davidson1,2, David R Karas1,2, Michael T Bigham1,2
1Akron Children's Hospital, Department of Pediatrics, Akron, Ohio.
Pediatric Quality & Safety
|September 30, 2021
Summary
Implementing electronic health record decision support tools significantly boosted lead screening rates in children. Universal screening at 12 months increased to 96%, and risk-based screening at 24 months rose to 74%.
Area of Science:
- Public Health
- Pediatric Medicine
- Quality Improvement Science
Background:
- Environmental lead exposure is a major public health issue, causing neurocognitive deficits.
- Low screening rates for blood lead levels hinder early detection and intervention.
- Targeted quality improvement was needed to enhance pediatric lead screening protocols.
Purpose of the Study:
- To improve universal blood lead level screening at 12 months of age.
- To increase risk-based blood lead level screening at 24 months of age.
- To achieve target screening rates of 95% for universal and 70% for risk-based screening.
Main Methods:
- Employed the Model for Improvement framework for systematic intervention development.
- Developed dynamic electronic health record order sets to prompt lead screening based on age and risk factors.
- Provided sites with regular feedback on screening performance metrics.
Main Results:
- Universal screening at 12 months increased from 71% to 96%, exceeding the target.
- Identified 70% of 2-year-olds as at-risk for lead exposure based on socioeconomic factors.
- Risk-based screening at 24 months improved from 41% to 74%, surpassing the goal.
Conclusions:
- Clinical decision support tools integrated into EHRs are effective in increasing lead screening rates.
- These tools can significantly improve pediatric preventive care and patient outcomes.
- The approach is adaptable for identifying patients needing other critical screenings or interventions.
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