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Improved Compliance of Pediatrics High Blood Pressure Guidelines in Well-Child Clinic Visits

Ei Ei Khin1,2,3, Maria Theresa Villanos1,2, Juliana Garcia Alvarado1,2

  • 1From the Pediatric Department, Texas Tech University Health Science Center El Paso, El Paso, TX.

Pediatric Quality & Safety
|August 8, 2023
PubMed

Insights

Pediatric providers improved adherence to childhood hypertension guidelines by using electronic medical record prompts. This enhances early detection and management of high blood pressure in children during well-child visits.

Area of Science:

  • Pediatrics
  • Cardiovascular Health
  • Public Health

Background:

  • Childhood hypertension is a growing concern, increasing the risk of adult cardiovascular disease.
  • Adherence to American Academy of Pediatrics (AAP) blood pressure (BP) guidelines is crucial for early detection and management.
  • Well-child visits present a key opportunity to screen and manage pediatric hypertension.

Purpose of the Study:

  • To improve adherence to AAP BP guideline steps to 75% in children aged 9-18 years during well-child visits.
  • To implement and evaluate interventions aimed at enhancing the systematic application of pediatric hypertension guidelines.

Main Methods:

  • Provider education on AAP high BP clinical practice guidelines.
  • Integration of guideline steps into the electronic medical record (EMR).
  • Utilizing Plan-Do-Study-Act (PDSA) cycles for iterative improvement, including provider feedback and EMR alerts.

Main Results:

  • Six of seven outcome measures achieved 86%-100% adherence after the second PDSA cycle.
  • Repeat manual BP measurement by providers improved significantly from 38% to 89% by the fourth PDSA cycle.
  • Demonstrated successful implementation of a systematic approach to pediatric hypertension management.

Conclusions:

  • Pediatric residents can significantly improve adherence to pediatric hypertension guidelines.
  • EMR integration and targeted interventions are effective strategies for enhancing guideline compliance.
  • Improved adherence facilitates better early detection and management of hypertension in children.

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