Increasing Screening Rates for Comorbidities in Adolescents with Elevated Body Mass Index in Pediatric Primary Care

Area of Science:

• Pediatric Endocrinology
• Public Health
• Quality Improvement Science

Background:

• Adolescents with elevated body mass index (BMI) face increased risks for serious health conditions like dyslipidemia, diabetes mellitus, and metabolic dysfunction-associated steatotic liver disease.
• Early identification through guideline-based screening allows for timely interventions, including lifestyle modifications, to improve long-term health outcomes.
• Current screening rates for pediatric patients with obesity remain low, with only 20% receiving recommended assessments.

Purpose of the Study:

• To enhance the rate of comorbidity screening in pediatric patients with obesity.
• To implement and evaluate a quality improvement project focused on improving screening adherence.

Main Methods:

• A multidisciplinary team utilized the Model for Improvement framework.
• Interventions included provider education and incentives, clinical decision support tools, and regular performance feedback.
• Screening rates were monitored using statistical process control charts.

Main Results:

• The project involved 9547 pediatric patients (aged 10+ years, BMI ≥95th percentile) from March to December 2022.
• Comorbidity screening rates increased from a baseline of 19.5% to 58%.
• The elevated screening rates were sustained for over three months, identifying numerous at-risk patients.

Conclusions:

• Evidence-based clinical decision support, coupled with provider education and engagement, is effective in increasing comorbidity screening rates.
• Quality improvement initiatives can significantly improve the detection of chronic disease risks in pediatric populations with obesity.
• Sustained improvements in screening highlight the potential for early intervention and better long-term health management.